Generalized tetanus: a case report

Abstract

Tetanus is a rare disease caused by Clostridium tetani, causing damage to the central nervous system with the development of muscle hypertension and attacks of generalized seizures caused by the action of the pathogenic toxin. Despite the availability of safe and effective vaccines, the urgency of the problem of tetanus incidence is high because a significant part of the population is not immunized against this disease, and severe manifestations of tetanus can be fatal.

This paper presents a clinical case of traumatic generalized tetanus in an 11-year-old patient. The absence of routine immunization against tetanus and emergency active–passive immunization contributed to disease development. The disease proceeded in a typical form, with the development of muscle spasms, myoclonia, trism, and convulsions. Specific tetanus serum was administered, pathogenetic therapy with anticonvulsants and muscle relaxants was performed, and the patient had clinical recovery and was discharged from the hospital.

Keywords

case report / generalized tetanus / spasms / risus sardonicus

References

[1] Yushchuk ND, Vengerov YuYa, editors. Infectious diseases. National leadership. Brief edition. Moscow: GEOTAR-Media; 2022. Р. 511–520. (In Russ).

[2] Инфекционные болезни. Национальное руководство. Краткое издание / под ред. Н.Д. Ющука, Ю.Я. Венгерова. Москва: ГЭОТАР-Медиа, 2022. С. 511–520.

[3] Komarovskaya EI, Perelygina OV. Current incidence of certain clostridial infections: gas gangrene and tetanus. BIOpreparations. Prevention, Diagnosis, Treatment. 2021;21(1):31–38. (In Russ). doi: 10.30895/2221-996X-2021-21-1-31-38

[4] Комаровская Е.И., Перелыгина О.В. Современная ситуация по заболеваемости отдельными клостридиальными инфекциями: газовая гангрена и столбняк // БИОпрепараты. Профилактика, диагностика, лечение. 2021. Т. 21, № 1. С. 31–38. doi: 10.30895/2221-996X-2021-21-1-31-38

[5] Kozlov AA, Shevchuk IV, Zavialov AE, Emelyanov AN. Generalized tetanus in an 11-year-old boy: A case report. Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2021;11(1):69–75. (In Russ). doi: 10.17816/psaic693

[6] Козлов А.А., Шевчук И.В., Завьялов А.Е., Емельянов А.Н. Генерализованная форма столбняка у ребенка 11 лет: клиническое наблюдение // Российский вестник детской хирургии, анестезиологии и реаниматологии. 2021. Т. 11, № 1. C. 69–75. doi: 10.17816/psaic693

[7] Kurmaeva DYu, Melnikov VL, Shubina YuA. A case of post-traumatic tetanus in the Penza region. Bulletin of Penza State University. 2020;(1):68–71. (In Russ).

[8] Курмаева Дж.Ю., Мельников В.Л., Шубина Ю.А. Случай посттравматического столбняка в Пензенской области // Вестник Пензенского государственного университета. 2020. № 1. С. 68–71.

[9] Pérez-González A, Fernández-Castro I, Araújo-Ameijeiras A, et al. Tetanus, analysis of 29 cases. Med Clin (Barc). 2022;159(3): 147–151. doi: 10.1016/j.medcli.2022.02.021

[10] Pérez-González A., Fernández-Castro I., Araújo-Ameijeiras A., et al. Tetanus, analysis of 29 cases // Med Clin (Barc). 2022. Vol. 159, N 3. P. 147–151. doi: 10.1016/j.medcli.2022.02.021

[11] Galina NP, Mindlina AYa, Polibin RV. Surveying children and adult vaccination program against diphtheria, tetanus, measles and viral hepatitis B in the Russian Federation. Russian Journal of Infection and Immunity. 2019;9(5-6):779–786. (In Russ). doi: 10.15789/2220-7619-2019-5-6-779-786

[12] Галина Н.П., Миндлина А.Я., Полибин Р.В. Анализ организации прививок детского и взрослого населения РФ против дифтерии, столбняка, кори и вирусного гепатита В // Инфекция и иммунитет. 2019. Т. 9, № 5-6. C. 779–786. doi: 10.15789/2220-7619-2019-5-6-779-786

[13] Drobinina AV, Butin MI, Ukolova ES, Likhogray LI. Emergency prevention of tetanus in surgical patients in Orenburg. Bulletin of medical Internet conferences. 2019;9(6):261. (In Russ).

[14] Дробинина А.В., Бутин М.И., Уколова Е.С., Лихограй Л.И. Экстренная профилактика столбняка у хирургических больных в г. Оренбурге // Бюллетень медицинских интернет-конференций. 2019. Т. 9, № 6. С. 261.

[15] Simovanyan EM, Goncharova EL, Denisenko VB. Tetanus is a difficult diagnosis in children. Children Infections. 2019;18(4):70–72. (In Russ). doi: 10.22627/2072-8107-2019-18-4-70-72

[16] Симованьян Э.М., Гончарова Е.Л., Денисенко В.Б. Трудности диагностики столбняка у детей // Детские инфекции. 2019. Т. 18, № 4. С. 70–72. doi: 10.22627/2072-8107-2019-18-4-70-72

[17] Sah SP, Khanal S, Dahal S, et al. Generalized tetanus in an elderly patient: A case report. Ann Med Surg (Lond). 2022;81:104465. doi: 10.1016/j.amsu.2022.104465

[18] Sah S.P., Khanal S., Dahal S., et al. Generalized tetanus in an elderly patient: A case report // Ann Med Surg (Lond). 2022. Vol. 81. P. 104465. doi: 10.1016/j.amsu.2022.104465

RIGHTS & PERMISSIONS

Eco-vector