What is the indication for a spatula test in the workup of tetanus (lockjaw)?

Updated: Jan 18, 2019
  • Author: Patrick B Hinfey, MD; Chief Editor: John L Brusch, MD, FACP  more...
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Answer

The spatula test is a simple diagnostic bedside test that involves touching the oropharynx with a spatula or tongue blade. In normal circumstances, it elicits a gag reflex, and the patient tries to expel the spatula (ie, a negative test result). If tetanus is present, patients develop a reflex spasm of the masseters and bite the spatula (ie, a positive test result).

In 400 patients, this test had a sensitivity of 94% and a specificity of 100%. [17] No adverse sequelae (eg, laryngeal spasm) were reported.


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