Short report: the spatula test: a simple bedside test to diagnose tetanus.

Four hundred patients with suspected tetanus were studied to determine the value of the spatula test to diagnose tetanus. A positive test result (reflex spasm of the masseters on touching the posterior pharyngeal wall) was seen in 359 (94%) of 380 patients with tetanus and in no patient without tetanus. Thirty-three of 400 patients (13 with tetanus and 20 with other diagnoses) had a negative test result (a gag reflex with attempted expulsion of the spatula). Thus, the test performed on presentation had a high specificity (100%) and sensitivity (94%) for diagnosing tetanus.