Local Tetanus in Man

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Abstract
Tetanus may be one of the easiest or of the most difficult diagnoses in medicine. The sequence of injury, followed within a few days by fleeting spasm and muscular contraction near the wound, and then trismus, diffuse hypertonicity, and violent spasmodic contractions of the neck, trunk, and limb muscles, terminating in generalized convulsions and in some cases death, is the familiar picture ofgeneralized tetanus. In contrast, twitching, localized fluctuating or intermittent spasm (often painful) in muscles of some part of the body, without known injury or wound, are usually not recognized as localized tetanus; or such symptoms may be mistaken for some other condition such as hysterical spasm, tetany, extrapyramidal rigidity, dystonia, or spasticity. Only the accidental discovery of tetanus bacilli, the later appearance of a mild trismus, or the subsidence of spasm over a period of weeks or months may provide clues to the true nature of the
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