Tetanus: still a killer in adults

Abstract

Objective: To determine the socio-demographic characteristics, clinical profile and outcome of the tetanus patients.
Study Design: Case Series
Place and duration of Study: SICU of Peoples University of Medical and Health sciences (PUMHS) Nawabshah,
from January 2010 to December 2012.
Methodology: The information obtained from the attendants of patients who presented with clinical features of
tetanus and classified into generalized and cephalic types and; severity was classified into mild, moderate severe and
very severe. Treatment was started immediately with protocol of supportive care; neutralization of circulating toxin
and eradication of the source of tetanospasmin. Details of socio-demographic data, clinical features, complications
and outcome were recorded and entered in a questionnaire before analysis.
Results: twenty two cases of tetanus were studied included males were 16 and females were 6. Six of 22 (27.3%)
patients had prior tetanus immunization while the other sixteen (72.7%) patients were not vaccinated or did not
know their tetanus immunization status. Lower limbs were most common of portal of entry 15 (68.2%). Most
of patients (95.5%) have generalized tetanus and 5 (22.7%) patients had very severe disease. Body stiffness/spasm
(100%), trismus (100%) and dysphagia (68.2%) were the three commonest presenting complaints. Complications of
tetanus were documented in 16 (72.7%) patients. Overall mortality was 68.2 %.
Conclusion: Tetanus prevalence is still high in interior Sind and is associated with high morbidity and mortality rate