Diagnosis and management of tetanus outside the intensive care unit: a case report

1st International Conference on Tropical Medicine and Infectious Diseases (ICTROMI) Faculty of Medicine Universitas Sumatera Utara

Bravo, T.E.^1 ; Siregar, M.L.^2 ; Jamil, K.F.^2

Department of Internal Medicine, Medical Faculty of Syiah Kuala University, Dr. Zainoel Abidin Hospital, Banda Aceh

23126, Indonesia^1

Division of Tropical and Infectious Diseases, Department of Internal Medicine, Medical Faculty of Syiah Kuala University, Dr. Zainoel Abidin Hospital, Banda Aceh

23126, Indonesia^2

关键词: Anaerobic conditions;    Antibiotic therapy;    Clostridium tetani;    General hospitals;    Mechanical ventilation;    Metronidazole;    Neuromuscular blockade;    Physical examinations;   

Others  :  https://iopscience.iop.org/article/10.1088/1755-1315/125/1/012067/pdf
DOI  :  10.1088/1755-1315/125/1/012067

来源: IOP

【 摘 要 】

Tetanus is an acute, toxin-mediated disease caused by Clostridium tetani infection. Under favorable anaerobic conditions, such as in the unclean environment, necrotic wounds, this ubiquitous bacillus may produce tetanospasmin, an extremely potent neurotoxin. A 38-year-old man was admitted to an emergency room, at Zainoel Abidin General Hospital, with the main complaint of back-muscle stiffness. Based on physical examination, he was fully alert with a slightly rapid breathing, trismus with the maximum oral cavity opening was only about one finger width, but rhisus sardonicus was not evident. Ten days before admission, while gardening, his left foot accidentally stabbed by wooden tree stake. We immediately started a single dose of tetanus immunoglobulin followed by intravenous metronidazole, penicillin G, and intravenous diazepam. Tetanus diagnosed by physical clinical finding. The management of tetanus patients including the use of immunoglobulin and antibiotic therapy, analgesia, sedation and neuromuscular blockade management and mechanical ventilation, the care was delivered outside the Intensive care unit.