Title : Fatal spasms: A successful case of very severe tetanus infection (case report)
Abstract:
Background:
Mortality of tetanus infection is directly proportional to the severity of infection. Tetanus is a preventable yet very fatal disease due to its autonomic dysfunction, muscle spasms, and rigidity. Aggressive intervention is necessary in order to manage the Tetanus infection that can last for 4-6 weeks.
Case Presentation:
This is a case of a 53 year old male who presented with stiffness of the back and trismus or lockjaw who had progression of muscle spasm and rigidity requiring tracheostomy. Prompt recognition of tetanus infection and early tracheostomy was done to secure the airway due to increasing rigidity. Patient was managed as a case of very severe tetanus infection due to autonomic dysfunction presenting with fluctuating episodes of hypotension, hypertension, bradycardia, and tachycardia. During the course of admission, the patient was placed in a dark and quiet room, treated with Metronidazole, sedatives and muscle relaxants. Patient developed complications such as ventilator associated pneumonia (VAP) and was treated accordingly with antibiotics. Eventually, the patient was discharged improved with a closed tracheostomy.
Conclusion:
Tetanus infection can be prevented by early vaccination. Tetanus prophylaxis can lead to a better prognosis once infected. When there is a suspicion of tetanus infection prompt recognition or early diagnosis, aggressive intervention is necessary to provide airway control for patients with tetanus infection.
Audience take away:
1. To present a case of a 53 year old male that was promptly recognized and managed as Tetanus infection.
2. Although Tetanus is a rare infection especially in first world countries, it is very fatal and has a high mortality. This will help physicians in managing Tetanus infection.
3. This case reiterates the importance of Tetanus Vaccination in preventing a severe case of tetanus infection.
