Severe Sympathetic Hyperactivity Associated With Tetanus

Cases of tetanus showing clinical features compatible with a syndrome of sympathetic hyperactivity have previously been observed,¹,²although it was only recently that Kerr et al³provided some evidence that the source was the sympathetic nervous system. The presence of the syndrome has been considered to denote a relatively poor prognosis,⁴and therapy has been aimed at suppressing the hyperactivity to decrease mortality.⁵We treated a particularly severe form of this complication with successful therapy. Patient Summary A 38-year-old woman was admitted to the Johannesburg Hospital on July 8, 1970. Six weeks prior to admission, she developed an "influenza-like" illness for which she received a course of penicillin injections. Two days before being admitted to the hospital, she consulted her doctor about her complaints of severe backache and a sensation of stiffness in the mouth. She was given trifluoperazine hydrochloride and diazepam and was told to