Published: 10 June 2021
Author(s): Akitoshi Ueno, Ippei Sakamaki, Yoshihiro Yamamoto
Issue: July 2021

An 86-year-old man with diabetes mellitus presented to our hospital with a 3-day history of difficulty opening his mouth. He reported that he had injured his right index finger while farming 15 days ago, resulting in a 1-cm-diameter red bruise. He had not received any diphtheria, tetanus, and pertussis vaccinations. He was afebrile and alert, presenting no mental status changes. Physical examination revealed a stiff neck, trismus, and spasmodic laughter (Fig. 1). Blood tests showed leukocytosis, high creatinine kinase, and high glucose levels.


Stay informed on our latest news!


This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.