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"identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Trismo y hematoma oral, una presentación rara del tétanos" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:6 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 514 "Ancho" => 756 "Tamanyo" => 29754 ] ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 69-year-old woman presented with painful severe trismus without fever of one week of evolution accompanied by odynophagia and dysphagia despite treatment with amoxicillin–clavulanic. Physical examination, nasofibroscopy and blood test showed no alterations. A haematoma on the floor of the mouth appeared 4<span class="elsevierStyleHsp" style=""></span>h after admission (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). The CT-scan showed no alterations (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). A wound on the leg made with agricultural tools preceding the beginning of the symptomatology was detected.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">The suspected diagnosis was tetanus, being treated with gammaglobulin, metronidazole, vaccination and performing a tracheotomy for airway control. The drainage of the haematoma demonstrated only a suffusion without organized collection. The patient evolved favourably and after a week of admission tracheostomy closure was performed and she was discharged, currently being asymptomatic.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Tetanus is a severe, life-threatening infectious disease present worldwide, being its incidence very low in developed countries. Trismus is probably the main and earliest sign of the disease, although is a common symptom in general clinical practice. Only one case of spontaneous intraoral mass associated with trismus in tetanus has been reported in the literature, having occurred more likely because of muscle rupture after prolonged spasm of the musculature on the floor of the mouth.</p><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Disclosures</span><p id="par0020" class="elsevierStylePara elsevierViewall">This research involved human participants and was approved by the Hospital's Ethics Committee. Informed consent was obtained from all individual participants included in the study.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Conflict of interests</span><p id="par0025" class="elsevierStylePara elsevierViewall">The authors declare no conflict of interests.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0010" "titulo" => "Disclosures" ] 1 => array:2 [ "identificador" => "sec0015" "titulo" => "Conflict of interests" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:2 [ 0 => array:6 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 558 "Ancho" => 752 "Tamanyo" => 84192 ] ] ] 1 => array:6 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 514 "Ancho" => 756 "Tamanyo" => 29754 ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735735/0000007100000002/v1_202004040728/S2173573520300351/v1_202004040728/en/main.assets" "Apartado" => array:4 [ "identificador" => "5869" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images in otorhinolaryngology" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735735/0000007100000002/v1_202004040728/S2173573520300351/v1_202004040728/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173573520300351?idApp=UINPBA00004N" ]
Journal Information
Vol. 71. Issue 2.
Pages 129-130 (March - April 2020)
Vol. 71. Issue 2.
Pages 129-130 (March - April 2020)
Images in Otorhinolaryngology
Trismus and oral haematoma, a rare presentation of tetanus
Trismo y hematoma oral, una presentación rara del tétanos
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a Otorhinolaryngology – Head and Neck Surgery Department, Complexo Hospitalario Universitario A Coruña (CHUAC), A Coruña, Galicia, Spain
b Clinical Research in Medicine, International Center for Doctorate and Advanced Studies (CIEDUS), Universidade de Santiago de Compostela (USC), Santiago de Compostela, Galicia, Spain
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