The authors are presenting our experience of managing an interesting case of a 12-year-old girl who presented to our clinic with otorrhea
for 3 months and trismus for 1 week. Examination showed bilateral ear discharge with central perforations in tympanic membranes, palatal
paralysis and trismus. Systemic examination revealed only mild stiffness of hand muscles. CT-scan head and neck was done to look for
intracranial complications of otitis media. However; it revealed only decreased pneumatisation of mastoid cells. She was admitted in the
hospital and started on intravenous and local antibiotics after sending ear swab and blood cultures. But she showed no improvement in 48 h.
So on the clinical suspicion (trismus and stiffness of hands) remote possibility of otogenic tetanus was considered and she was given tetanus
toxoid and immunoglobulins. She gradually showed improvement in her symptoms. Thereafter, culture from ear discharge was also reported
positive for Clostridium tetani .