Snapshot A 4-day-old girl presents to the pediatric emergency room for inability to suck or cry. The mom reports that since birth, she has been feeding, sucking, and crying normally until this morning. She also reports that she herself had not had any of the recommended vaccines as she grew up in a family that had refused vaccines. On physical exam, the baby girl is stiff and fails to cry during exam. She is also in opisthotonos. When given a pacifier, she also fails to suck. She is given a benzodiazepine for the spasm and appropriate treatment. She is admitted for further management. Introduction Classification login to view 5 more bullets Associated conditions login to view 5 more bullets Prevention login to view 8 more bullets Epidemiology Demographics login to view 2 more bullets Risk factors login to view 4 more bullets ETIOLOGY Pathogenesis login to view 4 more bullets Presentation Symptoms login to view 4 more bullets Physical exam login to view 12 more bullets Studies Serology or culture login to view 1 more bullet Making the diagnosis login to view 1 more bullet Differential Bacterial meningitis login to view 2 more bullets Treatment Management approach login to view 4 more bullets Conservative login to view 3 more bullets Medical login to view 12 more bullets Prophylaxis login to view 15 more bullets Complications Respiratory compromise from spasm of respiratory muscles Aspiration pneumonia Contractures Prognosis Spasms last for ~ 1 month Mortality can be high if not treated