Journal of Infectious Diseases and Treatment Open Access

BACKGROUND

Tetanus is an acute potentially fatal disease caused by clostridium tetani which produces a powerful neurotoxin which affects the central nervous system. Wherever the immunization programs are in place the incidence of tetanus declines and the age distribution of case patients shifts to reflect under immunization. So due to lack of proper immunization programs tetanus is still persistent in low socioeconomic strata of society.

CASE SERIES IN TETATNUS

There are four case reports observed in 6 months duration from September 2019 to February 2020. Common factors being: All of them belong to low socioeconomic strata having lack of knowledge for vaccination and inappropriate wound care. Presented with complaints of repeated involuntary painful contractions, trismus and opisthotonus position. On questionnaire , all of them were unvaccinated and early detection of wound also no appropriate wound management was done. All these cases were diagnosed clinically as case of tetanus and they were nursed in a dark quiet room treated with tetanus toxoid , tetanus immunoglobulin. Early tracheostomy and mechanical ventilation with sedation was done. Out of the four 3 survived , 1 expired.

DISCUSSION

Treatment aims to reduce pain and prevent complications. Human Tetanus Immunoglobulin i.m. 300 IU Metronidazole is the drug of choice Supportive care: Muscle relaxants -Diazepam,MgSO4 Neuromuscular blocking agents :Vecuronium ,Pancuronium Autonomic instability managed by Alpha and Beta Adrenergic blocking agents. CONCLUSION: Even though tetanus is a high fatal disease vaccination and appropriate wound management can prevent the disease. Early hospitalilstion and proper supportive treatment improves clinical outcome.

CONCLUSION

Even though tetanus is a high fatal disease vaccination and appropriate wound management can prevent the disease. Early hospitalilstion and proper supportive treatment improves clinical outcome.

References

1. Ayoola OO, Orimadegun AE, Akinsola AK, Osinusi K (2005) A five-year review of childhood mortality at the University College Hospital, Ibadan. West Afr J Med 24: 175â??179.
2. WHO (2012) Why Maternal and Neonatal Tetanus elimination?Maternal and Neonatal Tetanus (MNT) elimination.
3. UNICEF (2013)Book Table 3: Health (Editor ed.^eds.)City: United Nations Childrenâ??s Fund (UNICEF). Health 108â??111.
4. Brown VB, Oluwatosin OA (2012) Socio-demographic factors associated with childhood immunization uptake in Akinyele Local Government Area, Oyo State, Nigeria.Afr J Med Med Sci 41: 161â??167.
5. Antai D (2012) Gender inequities, relationship power, and childhood immunization uptake in Nigeria: a population-based cross-sectional study.Int J Infect Dis 16: 136â??145.
6. Blencowe H, Lawn J, Vandelaer J, Roper M, Cousens S (2010) Tetanus toxoid immunization to reduce mortality from neonatal tetanus.Int J Epidemiol 39: 102â??109.
7. Brabin L, Fazio-Tirrozzo G, Shahid S, Agbaje O, Maxwell S, Broadhead R, Briggs N, Brabin B (2000) Tetanus antibody levels among adolescent girls in developing countries.Trans R Soc Trop Med Hyg 94: 455â??459.