A 7-year-old boy is brought to the emergency department because of a 6-hour history of involuntary muscle contractions and pain in his back and neck. Last week, he fell while playing in the sandbox and scraped his knees. He has not received any vaccinations since birth. His temperature is 38.5°C (101.3°F). He is diaphoretic. Examination shows inability to open his mouth beyond 1 cm. There is hyperextension of the lumbar spine and resistance to neck flexion. Which of the following is the best approach to establishing diagnosis in this patient?

Question

Quizplus · Accepted Answer

Eductional Objective: Tetanus is a clinical diagnosis that should be suspected in patients who have characteristic symptoms (eg, lockjaw, muscle pain/spasms, difficulty swallowing), particularly if they are unlikely to be adequately vaccinated or have an antecedent cutaneous injury.

A 7-Year-Old Boy Is Brought to the Emergency Department Because