A 32-year-old man presents with jaw stiffness and painful generalized muscle spasms 1 week after a puncture wound from a rusty nail. Vital signs show BP 145/92 mmHg, HR 110/min, RR 22/min, temperature 38.2°C, SpO2 98% on room air. Examination reveals risus sardonicus, opisthotonos, and positive Kernig sign. Serum electrolytes and lumbar puncture are normal. He has not received tetanus prophylaxis in 10 years. Which diagnosis best explains these findings?
- A)Lambert Eaton myasthenic syndrome
- B)Myasthenia gravis
- C)TetanusGABARITO
- D)Spinal muscular atrophy
- E)Botulism
Explicação
Tetanospasmin blocks release of inhibitory neurotransmitters from spinal interneurons, producing disinhibited motor activity with trismus, opisthotonos, and diffuse painful rigidity. This pattern contrasts sharply with the flaccid paralysis seen in botulism. Ver explicação completa e trilha adaptativa →