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A 66-year-Old woman was referred to our hospital for evaluation and treatment of trismus and stiffness of the neck muscles. There were no laboratory abnormalities. She was diagnosed as tetanus and treated in internal medicine of neurology. A dose of 2.4 million U penicillin-G was administered on the day of admission. Furthermore, 3000 U of antitetanic human immunoglobulin and 0.5 ml of tetanus toxoid were administered intravenously for 2 days. She was discharged on the 32th day uneventfully. However generalized spasms had developed, a critical condition was avoided by initiating proper treatment for tetanus. Although tetanus has become a rare disease, it should be included in the differential diagnosis when treating the patient who has trismus. Severe trismus associated with clenching is an important sign for tetanus. The early recognition and treatment of tetanus would seem essential to avoid morbidity and mortality associated with the disease.", "subitem_description_type": "Abstract"}, {"subitem_description": 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