Generalized Tetanus in an Unvaccinated 52-Year-Old Male Gardener: Diagnostic and Therapeutic Challenges in a Low-Resource Setting.

Tetanus remains a life-threatening but preventable disease, which continues to manifest in adults lacking sufficient tetanus vaccination and accessibility to tetanus immunoglobulin (TIG). The case discussed is of an unvaccinated 52-year-old Pakistani male patient who developed progressive trismus, difficulty in swallowing, and general spasms following a minor foot wound. The early symptomatology was attributed to psychological stress or heat exhaustion; thus, there was an initial delay in diagnosis. His clinical course was further complicated by the unavailability of TIG, severe autonomic dysfunction, and respiratory compromise requiring prolonged mechanical ventilation and intensive care support. This case is consistent with global patterns, in which unvaccinated adult males with neglected wounds are disproportionately affected, while delayed diagnosis and limited access to immunoglobulin contribute to poorer outcomes. Although intensive care management may help control complications, prolonged recovery with persistent functional impairment is common in the absence of definitive toxin neutralization. This case underscores the need for strengthened tetanus booster vaccination programs, increased clinical awareness of atypical presentations, and resource-sensitive healthcare policies to ensure timely availability of TIG in emergency settings.