Tetanus differential diagnosis: Difference between revisions
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| style="background: #F5F5F5; padding: 5px;" | [[Meningitis]]<ref name="pmid24326618">{{cite journal| author=Chow E, Troy SB| title=The differential diagnosis of hypoglycorrhachia in adult patients. | journal=Am J Med Sci | year= 2014 | volume= 348 | issue= 3 | pages= 186-90 | pmid=24326618 | doi=10.1097/MAJ.0000000000000217 | pmc=4065645 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24326618 }} </ref><ref name="pmid22880096">{{cite journal| author=Leen WG, Willemsen MA, Wevers RA, Verbeek MM| title=Cerebrospinal fluid glucose and lactate: age-specific reference values and implications for clinical practice. | journal=PLoS One | year= 2012 | volume= 7 | issue= 8 | pages= e42745 | pmid=22880096 | doi=10.1371/journal.pone.0042745 | pmc=3412827 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22880096 }} </ref> | | style="background: #F5F5F5; padding: 5px;" | [[Meningitis|Viral Meningitis]]<ref name="pmid24326618">{{cite journal| author=Chow E, Troy SB| title=The differential diagnosis of hypoglycorrhachia in adult patients. | journal=Am J Med Sci | year= 2014 | volume= 348 | issue= 3 | pages= 186-90 | pmid=24326618 | doi=10.1097/MAJ.0000000000000217 | pmc=4065645 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24326618 }} </ref><ref name="pmid22880096">{{cite journal| author=Leen WG, Willemsen MA, Wevers RA, Verbeek MM| title=Cerebrospinal fluid glucose and lactate: age-specific reference values and implications for clinical practice. | journal=PLoS One | year= 2012 | volume= 7 | issue= 8 | pages= e42745 | pmid=22880096 | doi=10.1371/journal.pone.0042745 | pmc=3412827 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22880096 }} </ref> | ||
| style="background: #DCDCDC; padding: 5px;" | | | style="background: #DCDCDC; padding: 5px;" | | ||
* [[Fever]] | * [[Fever]] | ||
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*Lymphocytes>granulocytes | *Lymphocytes>granulocytes | ||
| style="background: #DCDCDC; padding: 5px;" | | | style="background: #DCDCDC; padding: 5px;" | | ||
* Supportive | |||
** [[Analgesics]] for [[pain]]. | |||
** [[Acetaminophen]] for [[fever]]. | |||
* Anti-viral therapy: | |||
** [[Acyclovir]] <sup>[[Viral meningitis medical therapy#cite note-pmid15319091-2|[2]]]</sup> | |||
** [[Pleconaril]] | |||
|- | |- | ||
| style="background: #F5F5F5; padding: 5px; text-align: center;" | [[Stiff man syndrome]] | | style="background: #F5F5F5; padding: 5px; text-align: center;" | [[Stiff man syndrome]] | ||
| style="background: #DCDCDC; padding: 5px;" | | | style="background: #DCDCDC; padding: 5px;" | | ||
| style="background: #F5F5F5; padding: 5px; text-align: center;" | | * Marked rigidity | ||
* [[Spasms]] | |||
** Intermittent | |||
** Painful | |||
** Absent during sleep | |||
| style="background: #F5F5F5; padding: 5px; text-align: center;" | | |||
* [[Diaphoresis]] | |||
* [[Arterial hypertension]] | |||
* [[Tachypnea]] | |||
* [[Cyanosis]] | |||
* [[Apnea]], [[tachypnea]] | |||
* [[Respiratory arrest]] | |||
* Dilatation of the pupils | |||
* [[Tachycardia]] | |||
| style="background: #DCDCDC; padding: 5px;" | | | style="background: #DCDCDC; padding: 5px;" | | ||
* [[CSF]] has | |||
** Elevated [[IgG]] | |||
** [[Oligoclonal bands]] | |||
* Positive anti-GAD antibodies | |||
* Elevated [[creatine kinase]] | |||
* Normal CBC & ESR | |||
| style="background: #DCDCDC; padding: 5px;" | | | style="background: #DCDCDC; padding: 5px;" | | ||
* [[Benzodiazepines]] | |||
* B[[Baclofen|aclofen]] | |||
* [[Vigabatrin]] | |||
* [[Valproic Acid]], [[Neurontin]] | |||
* Injected [[botulinum toxin]] | |||
* [[Prednisone]], [[plasmapheresis]], [[IVIG]] ( some success) | |||
|- | |- | ||
| style="background: #F5F5F5; padding: 5px; text-align: center;" | [[Drug]] induced | | style="background: #F5F5F5; padding: 5px; text-align: center;" | [[Drug]] induced | ||
Revision as of 16:40, 12 June 2017
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Tetanus Microchapters |
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Tetanus differential diagnosis On the Web |
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American Roentgen Ray Society Images of Tetanus differential diagnosis |
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Risk calculators and risk factors for Tetanus differential diagnosis |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Michael Maddaleni, B.S.; Associate Editor(s)-in-Chief: Usama Talib, BSc, MD [2]
Overview
Tetanus must be differentiated from strychnine poisoning, dental infections, drug reactions, hypocalcemia, meningitis, stroke and stiff man syndrome.[1]
Differentiating Tetanus from other Diseases
Some of the other diseases that need to be considered when trying to diagnose tetanus include:[2][3][4]
- Dental abscess
- Drug reactions
- Hypocalcaemia
- Meningitis
- Stiff man syndrome
- Strychnine poisoning
- Parkinson's disease
Differential for Unilateral Involuntary Face Movements
The differential diagnosis for abnormal one sided movements of the face includes:[5][6][7][8][9][10][11][12]
- Tetanus associated trismus
- Temporomandibular joint (TMJ) dysfunction
- Tetany
- Unilateral jaw dystonia
- Exclusive facial myokymia
- Exclusive hemifacial spasm
- Multiple sclerosis (MS) associated tonic spasms
- Focal motor epilepsy
- Hemimasticatory spasm in the presence or absence hemiatrophy of the face
| Disease | Diagnosis | Treatment | ||
|---|---|---|---|---|
| Symptoms | Signs | Laboratory Findings | ||
| Tetanus |
|
|
|
|
| Neuroleptic Malignant Syndrome |
|
|
| |
| Viral Meningitis[13][14] |
|
|
|
|
| Stiff man syndrome |
|
|
|
|
| Drug induced |
|
|||
| Strychnine poisoning |
|
|||
| Hypocalcaemia | ||||
| Dental abscess | ||||
| Parkinson's disease | ||||
References
- ↑ Anisha Doshi, Clare Warrell, Dima Dahdaleh & Dimitri Kullmann (2014). "Just a graze? Cephalic tetanus presenting as a stroke mimic". Practical neurology. 14 (1): 39–41. doi:10.1136/practneurol-2013-000541. PMID 24052566. Unknown parameter
|month=ignored (help) - ↑ E. Andreadou, E. Kattoulas, C. Sfagos & D. Vassilopoulos (2007). "Stiff person syndrome: avoiding misdiagnosis". Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology. 28 (1): 35–37. doi:10.1007/s10072-007-0745-9. PMID 17385093. Unknown parameter
|month=ignored (help) - ↑ Lisa Mitchell, William Adams & Francois Aspesberro (2017). "Case 6: Episodic Stiffness in a 30-month-old Girl". Pediatrics in review. 38 (1): 52–53. doi:10.1542/pir.2014-0142. PMID 28044038. Unknown parameter
|month=ignored (help) - ↑ P. D. Thompson, J. A. Obeso, G. Delgado, J. Gallego & C. D. Marsden (1986). "Focal dystonia of the jaw and the differential diagnosis of unilateral jaw and masticatory spasm". Journal of neurology, neurosurgery, and psychiatry. 49 (6): 651–656. PMID 3734821. Unknown parameter
|month=ignored (help) - ↑ P. D. Thompson, J. A. Obeso, G. Delgado, J. Gallego & C. D. Marsden (1986). "Focal dystonia of the jaw and the differential diagnosis of unilateral jaw and masticatory spasm". Journal of neurology, neurosurgery, and psychiatry. 49 (6): 651–656. PMID 3734821. Unknown parameter
|month=ignored (help) - ↑ J. R. Berger, W. A. Sheremata & E. Melamed (1984). "Paroxysmal dystonia as the initial manifestation of multiple sclerosis". Archives of neurology. 41 (7): 747–750. PMID 6743065. Unknown parameter
|month=ignored (help) - ↑ W. B. Matthews (1975). "Paroxysmal symptoms in multiple sclerosis". Journal of neurology, neurosurgery, and psychiatry. 38 (6): 617–623. PMID 1151430. Unknown parameter
|month=ignored (help) - ↑ P. D. Thompson & W. M. Carroll (1983). "Hemimasticatory spasm--a peripheral paroxysmal cranial neuropathy?". Journal of neurology, neurosurgery, and psychiatry. 46 (3): 274–276. PMID 6842234. Unknown parameter
|month=ignored (help) - ↑ P. D. Thompson & W. M. Carroll (1983). "Hemimasticatory and hemifacial spasm: a common pathophysiology?". Clinical and experimental neurology. 19: 110–119. PMID 6568919.
- ↑ L. R. Jenkyn, D. B. Walsh, C. M. Culver & A. G. Reeves (1977). "Clinical signs in diffuse cerebral dysfunction". Journal of neurology, neurosurgery, and psychiatry. 40 (10): 956–966. PMID 591973. Unknown parameter
|month=ignored (help) - ↑ J. D. Rugh & W. K. Solberg (1976). "Psychological implications in temporomandibular pain and dysfunction". Oral sciences reviews. 7: 3–30. PMID 775369.
- ↑ Bond WS (1984). "Detection and management of the neuroleptic malignant syndrome". Clin Pharm. 3 (3): 302–7. PMID 6145537.
- ↑ Chow E, Troy SB (2014). "The differential diagnosis of hypoglycorrhachia in adult patients". Am J Med Sci. 348 (3): 186–90. doi:10.1097/MAJ.0000000000000217. PMC 4065645. PMID 24326618.
- ↑ Leen WG, Willemsen MA, Wevers RA, Verbeek MM (2012). "Cerebrospinal fluid glucose and lactate: age-specific reference values and implications for clinical practice". PLoS One. 7 (8): e42745. doi:10.1371/journal.pone.0042745. PMC 3412827. PMID 22880096.