2008 Volume 19 Issue 5 Pages 279-282
A 79-year-old woman was transferred to an emergency care center because of difficulty opening her mouth. Major trauma was not evident but she had a scab from a minor injury on the right fifth finger. Three days later, sudden respiratory failure and heart failure developed with an inverted T wave in electrocardiogram, Takotsubo-like wall motion and slightly elevated creatine kinase and troponin T. We isolated Clostridium tetani from the scab on her finger and from soil at the farm where she worked. Tetanus was clinically and biologically diagnosed and she was sedated, ventilated and given circulatory support. She was discharged on hospital day 35. Isolation of C. tetani is very rare and to our knowledge, this is the first time that C. tetani has been isolated from a scab. C. tetani infection cannot be discounted even when a wound is in a stage of advanced healing and such wounds should always be debrided for therapeutic purposes.
