Jaw stiffness post contaminated foot wound from stepping on | Figure 1

ray007

Anesthesiology Resident

Jaw stiffness post contaminated foot wound from stepping on a dirty nail

A 16 year old boy was brought by his parents to ER. Four days ago after playing football he stepped over a dirty nail on his way home. He didn’t pay much attention to his wound and did not wash it rapidly. He now presents with difficulty in opening his mouth and his parents describe his jaw: “Like a lock”. He has no pain in his jaw. His mouth angles are raised, his neck is rigid as well as his abdomen. His back looks like an arch.

What is your provisional diagnosis?

What are other possible clinical features to look for?

What is the causative organism? By which mechanism does it cause this disease?

What are other diseases that can mimic such presentation?

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