Tetanus: still a killer in adults

ABSTRACT

To determine the socio-demographic characteristics, clinical profile and outcome of the tetanus patients. Case Series SICU of Peoples University of Medical and Health sciences [PUMHS] Nawabshah, from January 2010 to December 2012. 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. 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%. Tetanus prevalence is still high in interior Sind and is associated with high morbidity and mortality rate