DEAR DR. GOTT: A patient bit my niece at work while she and others were trying to restrain her. Afterward, my niece was asked when she had her last tetanus shot; she wasn’t sure. Rather than giving her a booster shot, she received antibiotics and dressings for the wound. A few weeks later, her fist began to clench and she had to place a ball in her hand to keep her nails from digging into her palm. She has severe pain in her arm and recently developed cellulitis. Workers’ compensation delayed treatment, and she is now classified as permanently disabled. Do you have any knowledge in this area that would help her try to regain the use of her arm?

DEAR READER: Tetanus, also known as “lockjaw,” is a serious condition caused by the bacteria Clostridium tetani. It is fairly rare, thanks to the vaccine, but about 1 million cases occur each year worldwide. Less developed countries, where vaccination rates are lowest, have the highest incidence rates.
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