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A 15-year-old boy presented with episodic abnormal movements of the right upper limb, neck, and jaw for 10 days associated with pain and spasms, following a penetrating injury to his right hand 2 months ago. He was successfully managed for tetanus with antitoxin, antibiotics, wound debridement, and supportive care. He was found to have protective tetanus antibody levels (1.1 IU/mL). To encounter tetanus in a vaccinated individual with an atypical focal presentation is a cause for concern and requires awareness to avoid delay in diagnosis and management.
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Kaur et al. (2024) studied this question.
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