Tetanus: problems of differential diagnosis in the presence of contemporaneous administration of metoclopramide
Gaspari, R.; Mignani, V.; Kovacs, A.; Clemente, A.; Visocchi, M.; Proietti, R.
Minerva Anestesiologica 62(12): 409-412
1996
ISSN/ISBN: 0375-9393 PMID: 9102592 Document Number: 457779
Here we report a clinical case concerning differential diagnosis between tetanus and metoclopramide intoxication. A 67 year old woman was admitted to our intensive care unit complaining of both trisma and four limbs hypertone soon after a massive metoclopramide bolus administration. The patient was affected by a chronicle renal insufficiency and a diagnosis of metoclopramide intoxication was made. The long lasting dystonic symptomatology together with respiratory insufficiency ruled out the hypothesis of drug overdose. The intensive care physicians would take into account that at least a 24 hours clinical observation is mandatory in order to perform a correct diagnosis.