[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-458563-105":59,"doc-detail-458563-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","clinically-diagnosed-tetanus-in-a-58-year-old-female-with-breast-fungating-mass","Clinically diagnosed tetanus in a 58-year-old female with breast fungating mass","","Tetanus is a rare but potentially fatal disease, usually linked to traumatic wounds, yet necrotic malignancies can also provide an entry site for Clostridium tetani. This case describes a 58-year-old woman with a 3-year history of a progressively enlarging, fungating left breast mass who presented with trismus; tetanus was diagnosed clinically. She received antitetanus globulin and metronidazole, plus supportive wound cleansing after refusal of surgical debridement. Findings emphasize early recognition in low-resource settings, especially when immunization histories are uncertain.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/clinically-diagnosed-tetanus-in-a-58-year-old-female-with-breast-fungating-mass/458563/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/clinically-diagnosed-tetanus-in-a-58-year-old-female-with-breast-fungating-mass/458563.png","ImageObject",300,407,{"name":92,"@type":93},"Stanford","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-02","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":39},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"How was tetanus diagnosed in this 58-year-old woman?","Question",{"text":112,"@type":113},"Tetanus was diagnosed clinically based on her presentation with trismus in the context of a necrotic, fungating breast mass.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What treatments were provided, and what was not performed?",{"text":117,"@type":113},"The patient received antitetanus globulin, metronidazole, local wound cleansing, and supportive management. Surgical debridement was not performed due to the patient’s refusal.",{"name":119,"@type":110,"acceptedAnswer":120},"Why should tetanus be considered in patients with necrotic tumors?",{"text":121,"@type":113},"Necrotic tumors can act as an infection entry point for Clostridium tetani, and early intervention is crucial to reduce morbidity and prevent complications, particularly when immunization histories are uncertain in low-resource settings.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},458563,1790820775,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":39,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":19,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":52,"preview_page_count":4},2336477552062,"https://ap-avatar.wpscdn.com/davatar_994ba38a5ba835b3df7d355c54d3ed8d","Cruz etal. Tropical Medicine and Health (2026) 54:8  \n[https://doi.org/10.1186/s41182-025-00878-3](https://doi.org/10.1186/s41182-025-00878-3)  \nTropical Medicine and Health  \n CASE REPORT Open Access  \nClinically diagnosed tetanus in a 58-year-old female with breast fungating mass  \nMaria Fe R. Cruz 1, Chris Smith2,3,4, Kensuke Takahashi2,5, Su Myat Han2,4,6* and Jeffrey A. Verona 1  \nAbstract  \nBackground Tetanus remains a rare but potentially fatal disease, typically associated with traumatic wounds. However, necrotic malignancies such as fungating breast tumors may also serve as an entry point for Clostridium tetani infection.  \nCase presentation We report the case of a 58-year-old female with a 3-year history of a fungating left breast mass who presented with trismus. A diagnosis of tetanus was made clinically. The patient received treatment with antitetanus globulin, metronidazole, and she was placed in a dark room with sound insulation and shielding. The surgical team was consulted for wound management. However, in accordance with the patient’s refusal, surgical debridement was not performed. Instead, local wound cleansing and supportive management were initiated.  \nConclusions Tetanus should be considered in patients with necrotic tumors presenting with trismus, especially in low-resource settings where immunization histories are uncertain. Early intervention is crucial to reduce morbidity and prevent complications.  \nKeywords Tetanus, Breast mass, Necrotic wound, Trismus  \nBackground  \nTetanus is a neurological condition caused by the neurotoxin tetanospasmin, produced by Clostridium tetani [1, 2]. Clinically, tetanus is classified into four forms: generalized, localized, cephalic, and neonatal. Generalized tetanus is the most common and is characterized by  \n*Correspondence: Su Myat Han [pearl.june@gmail.com](pearl.june@gmail.com)  \n1 Adult Infectious Disease and Tropical Medicine Department, San Lazaro Hospital, Manila, Philippines  \n2 School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan  \n3 Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK  \n4 San Lazaro Hospital-Nagasaki University Collaborative Research Office, San Lazaro Hospital, Manila, Philippines  \n5 Acute and Critical Care Unit, Nagasaki University Hospital, Nagasaki, Japan  \n6 Department of Infectious Disease Epidemiology and Dynamics, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan  \ntrismus, generalized rigidity, and reflex spasms. Localized tetanus presents with muscle rigidity confined to the region of injury, while cephalic tetanus, typically following head or neck wounds, involves cranial nerve palsies. Neonatal tetanus occurs in newborns due to umbilical stump contamination. Pathophysiologically, tetanospasmin acts at the inhibitory synapses of the central nervous system. After entering peripheral nerves at the wound site, the toxin undergoes retrograde axonal transport to the spinal cord and brainstem, where it cleaves vesicleassociated membrane protein (VAMP, also known as synaptobrevin), a key component of the SNARE complex involved in neurotransmitter release. This inhibition prevents the exocytosis of inhibitory neurotransmitters γ-aminobutyric acid (GABA) and glycine, leading to unchecked excitation of motor and autonomic neurons and the characteristic muscle rigidity and spasms of tetanus [1, 2]. Though most cases are associated with trauma, the disease may also result from chronic, necrotic wounds, including malignant tumors [3–8]. Ulcerated  \n© The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party","cbCaicT41eXV1Ixr","https://ap.wps.com/l/cbCaicT41eXV1Ixr","pdf",1021758,"English","# Abstract\n# Background\n# Case presentation\n## Presentation and diagnosis\n## Treatment and wound management\n# Conclusions","[{\"question\":\"How was tetanus diagnosed in this 58-year-old woman?\",\"answer\":\"Tetanus was diagnosed clinically based on her presentation with trismus in the context of a necrotic, fungating breast mass.\"},{\"question\":\"What treatments were provided, and what was not performed?\",\"answer\":\"The patient received antitetanus globulin, metronidazole, local wound cleansing, and supportive management. Surgical debridement was not performed due to the patient’s refusal.\"},{\"question\":\"Why should tetanus be considered in patients with necrotic tumors?\",\"answer\":\"Necrotic tumors can act as an infection entry point for Clostridium tetani, and early intervention is crucial to reduce morbidity and prevent complications, particularly when immunization histories are uncertain in low-resource settings.\"}]","Clinically diagnosed tetanus in a 58-year-old female with breast fungating mass | PDF",1790753709]