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Stanford Wessler, MD; Louis A. Avioli, MD

JAMA. 1969;207(1):123-127.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

DR. JOHN W. SULLIVAN, Junior Assistant Resident in Medicine, Jewish Hospital of St. Louis, and assistant in Medicine, Washington University School of Medicine: A 67-year-old white woman was admitted to the Jewish Hospital for the first time on July 30, 1968, because of shoulder and neck pain and inability to open her mouth. Eleven days before admission, a nail, thrown by a motorized lawnmower, had pierced her right calf. The nail was removed, the laceration sutured, and tetanus toxoid administered. On subsequent questioning the patient did not recall previous tetanus immunization. During the ensuing several days the patient noted a foul odor of the wound when she changed the dressing. Eight days after the injury, she first noted tightened facial muscles and a persistent pain between her scapulae. Shortly thereafter, she was unable to swallow her oral secretions. Her physician reopened the laceration, administered penicillin G potassium parenterally, and transferred . . . [Full Text PDF of this Article]

Author Affiliations
From the Department of Medicine, Jewish Hospital of St.Louis.

Footnotes
Reprint requests to 216 S Kingshighway, St. Louis 63110 (Dr. Wessler).

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