Clinical Practice and Cases in Emergency Medicine

Introduction: Tetanus is a rare but life-threatening disease caused by Clostridium tetani, characterized by generalized muscle rigidity, autonomic instability, and respiratory compromise. 

Case Report: We present a case of a 65-year-old male poultry hobbyist with type two diabetes who developed severe tetanus following a rooster-peck injury to his finger. The patient presented with progressive trismus and respiratory distress necessitating fiberoptic nasotracheal intubation and subsequent tracheostomy. Despite appropriate antimicrobial therapy, immunoglobulin administration, and sedation, the patient continued to exhibit spasms when sedation was reduced. 

Conclusion: This case highlights the ongoing risk of tetanus in under-immunized agricultural populations, the challenges of airway management in severe trismus, and the importance of maintaining vaccination awareness even in developed healthcare settings.