An unusual presentation of generalized tetanus as dysphagia

Tetanus is a disease caused by the toxin produced by Clostridium tetani, a Gram negative anaerobic spore forming bacillus. Infection acquired from body piercing and puncture wound; intravenous drug abuse, surgical interventions, septic abortion and through infected umbilical stump. After inoculation C.tetani transform into a vegetative rod shaped bacterium and produces metalloproteases such as tetanospasmin and tetanolysin. Tetanospasmin is responsible for painful muscle rigidity and autonomic instability via inactivating inhibitory neurotransmission. The role of tetanolysin is not known.