Clinical Peal:
临床典型病例：
40 yo previously healthy male in China who presents with prolonged “seizure” after receiving a cut on his foot while fishing 5 days ago.
40岁健康中国男性，五天前在钓鱼时脚上划了一个口子，现因长时间抽搐而来就诊。
Dx: Tetanus
诊断：破伤风
Clinical features:
临床表现：
Incubation period 4-14 days
潜伏期4－14天
3 clinical forms:
3种临床表现类型：
Local spasm
局部痉挛
Cephalic (rare) - cranial nerve involvement
头部（罕见）：面部神经表现
Generalized (most common) - Descending spasm: facial sneer (risus sardonicus), “locked jaw” trismus, neck stiffness, laryngeal spasm, abdominal muscle spasm.
全身（最常见）－下行性痉挛：面部抽搐性冷笑（risus sardonicus 痉笑），牙关紧闭（锁颌），颈部强直，喉咽部痉挛，腹肌痉挛。
Spasms continue to 3-4 weeks and can take months to fully recover
痉挛性抽搐可持续3－4周，甚至几个月才能恢复。
Complications: apnea, rhabodymyolysis, fracture/dislocations
合并症：窒息，肌溶解综合症，骨折／关节脱位
Treatment: supportive, benzodiazepines, RSI, Tetanus IG (3000-5000 units IM), wound debridement
治疗：支持性，安定类，气管插管，破伤风免疫球蛋白（3000－5000单位肌注），伤口清创。

References参考文献:
http://www.cdc.gov/vaccines/pubs/pinkbook/tetanus.html