Intraoperative Diagnosis and Use of Glidescope^tm Video Laryngoscope for Cephalic Tetanus

Steven Shulman, Yana Yasyulyanets, Patricia Kloser

Department of Anesthesiology, University of Medicine and Dentistry of New Jersey, Newark, USA.
Department of Medicine, St. Joseph’s Regional Medical Center, Paterson, USA.
Department of Medicine, University of Medicine and Dentistry of New Jersey, Newark, USA.

DOI: 10.4236/ojanes.2013.31008                

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 Glidescope^tm video laryngoscope in this unusual pathological condition.

Keywords

Tetanus; Intraoperative; Diagnosis; Glidescope

Conflicts of Interest

The authors declare no conflicts of interest.

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