Trismus and tetanus toxoid vaccine.

Background, - Tetanus immunization mandatory in France before the age of 18 months, is usually well tolerated Fever and local reaction at the site of injection are the most common side effects. We report a case of trismus ass ociated with tetanus immunization. Case report. - A 12-year-old boy was hospitalized for a trimus which occurr ed 22 h after a booster dose of tetanus polio vaccine. The spasm of mastica tor muscles was so severe that the patient had difficulties in elocution an d feeding. A moderate fever and a hypertonia of the lower limbs, were assoc iated. The trismus resolved itself, within about 5 min after diazepam intra venous infusion. After examination of the buccal cavity, a local cause was discarded The outcome,was favorable and the clinical status of the boy teas still normal sir months later. Discussion, - Although no similar cases have been published, 13 other compa rable adverse events associated with four vaccines containing tetanus toxoi d were reported to the manufacturer within a period of 12 years. During the same period, more than 66 millions doses of vaccines containing tetanus to xoid,cere distributed Trismus appeared to be more likely reported in adults after booster doses. Onset of the symptoms was between a few hours to 15 d ays. Outcome was always favor able. Conclusion, - Although trimus associated to tetanus toxoid immunization is rare and remains unexplained, physicians should be aware of this adverse ev ent. (C) 1999 Elsevier, Paris.