A case of generalized tetanus with classical ‘risus sardonicus’

A 50-year-old farmer presented with dysphagia and chest tightness following foot trauma for the last three days. On examination, he had nuchal rigidity, trismus, hypertonia. characteristic ‘Risus Sardonicus’ face was noticed (Figure 1). The patient also developed generalized painful spasms respiratory distress stridor, which an urgent tracheostomy done. Based on clinical presentation, a diagnosis of tetanus considered. He given 0.5 ml intramuscular toxoid 3000 IU human immunoglobulin.