Tropical Travel Trouble 003 Stiff in the Mouth
LITFL • Life in the Fast Lane Medical Blog
LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog
aka Tropical Travel Trouble 003
A 65 yr old woman from Ethiopia is visiting her grandchild for the first time in Europe. She is normally fit and well, physically active with a small-holding in Ethiopia. She does not take any medication and cannot remember the last time she saw a doctor. She presents to you with difficulty chewing 3 days after arriving in the UK. She describes it as being “stiff in the mouth”
Questions:
Q1. What is the differential diagnosis and how would you diagnose each?
Answer and interpretation
expand(document.getElementById('ddet1785030685'));expand(document.getElementById('ddetlink1785030685'))
Tetanus – clinical diagnosis and the one present in this case. Bacteriology is of little help, the organism is often not found and a positive wound culture for C. tetani does not prove that the organism is toxin producing.
Giant cell arterititis – ESR
Dental abscess – examination
Strychnine poisoning – history, most likely this will be of sudden onset and continuous, urinary levels can be obtained. Supportive care should be initiated. See Tox library – Strychnine poisoning.
Dystonic reactions – drug history, trial of benzatropine
Stiff person syndrome – most likely a diagnosis of exclusion but the presence of antibodies against GAD is the best indication of...
Source: Life in the Fast Lane - Category: Emergency Medicine Authors: Neil Long Tags: Clinical Cases Tropical Medicine tetanus Source Type: blogs
More News: Arrhythmia | Baclofen | Blogging | Brain | Burns | Cardiology | Cardiovascular | Children | Databases & Libraries | Diphtheria | Education | Emergency Medicine | Environmental Health | Ethiopia Health | Head Injury | Heart | Hospitals | Hypertension | Labetalol | Magnesium | Men | Metronidazole | Neurology | Nursing | Orthopaedics | Oxford University | Parenteral Nutrition | Penicillin | Perinatology & Neonatology | Poisoning | Pregnancy | Reflex Sympathetic Dystrophy | Respiratory Medicine | Spinal Cord Injury | Tetanus | Tetanus Diptheria Pertussis Vaccine Tdap,Dtap,Dpt | Tetanus Vaccine | Thyroid | Tropical Medicine | Universities & Medical Training | Vaccines | Whooping Cough (Pertussis) Vaccine