TITLE:
Intraoperative Diagnosis and Use of Glidescopetm Video Laryngoscope for Cephalic Tetanus
AUTHORS:
Steven Shulman, Yana Yasyulyanets, Patricia Kloser
KEYWORDS:
Tetanus; Intraoperative; Diagnosis; Glidescope
JOURNAL NAME:
Open Journal of Anesthesiology,
Vol.3 No.1,
January
31,
2013
ABSTRACT:
This case report describes the
clinical characteristics and management of a 38-year-old man with cephalic tetanus. He
presented with a massive facial infection after a dental procedure. After
induction of anesthesia, cephalic tetanus was clinically diagnosed during
induction based on the presence of a new facial nerve palsy and nuchal rigidity
even after the administration of succinylcholine. The first attempt at
intubation was unsuccessful with a Macintosh laryngoscope due to persistent
nuchal rigidity and lockjaw despite the use of succinylcholine. Consistent with
other reports, intubation was remarkably uncomplicated when the video
laryngoscope was used. Postoperatively, the Clostridium tetani infection progressed to generalized
tetanus and responded to supportive care. This case highlights the difficulties
of diagnosis, and supports the utility of the Glidescopetm video
laryngoscope in this unusual pathological condition.