An Unusual Presentation of Generalized Tetanus Following Post-Exposure Vaccination Complicated by Acute Motor Sensory Axonal Neuropathy: A Case Report.

Tetanus, caused by Clostridium tetani, remains a serious but preventable infection, with global incidence significantly reduced through widespread vaccination. We present the case of a 51-year-old man who developed severe tetanus following a minor nail prick injury, despite receiving tetanus toxoid and antibiotics. His condition rapidly progressed to trismus, hyperreflexia, continuous spasms, autonomic instability, and respiratory failure, requiring mechanical ventilation. A rare complication-acute motor sensory axonal neuropathy (AMSAN)-was identified, one of the first reported cases associated with tetanus. Despite aggressive treatment, the patient succumbed to multiorgan failure on day 22. This case highlights the high mortality of tetanus with short incubation periods, the challenge of managing autonomic instability, and the potential for rare complications like AMSAN, emphasizing the importance of timely recognition, intensive care, and management.