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Shonita Das

Abstract

TETANUS, A RARE CONDITION WHICH ALSO CAN HAPPEN IN IMMUNIZED INDIVIDUALS

Shonita,Das1 , Zuriyah Ariffin2

 

 Hospital Tengku Ampuan Rahimah, Kuala Lumpur Malaysia

 

 

Introduction

There is a low incidence of tetanus in developed countries as most people are fully immunized. However there are rare occasions of tetanus which can result in life threatening muscle spasm with respiratory insufficiency or autonomic dysfunction.Thus early recognition and treatment is required,

 

Case report

 

A 26 year old malay male fully immunized presented to emergency department with right sided involuntary painful spasms 6 days ago whereby IM ATT was given. Patient had come to Emergency multiple times and was discharged with painkillers. Initially there was a diagnostic dilemma until the episode was captured in a video. He was then admitted to the intensive care unit whereby IM antitetanus Immunoglobulin together with antibiotics was given and wound debridement for the right knee was done. Subsequently patients spasms reduced and patient was eventually discharged.

 

Discussion & Conclusion

 

In developed countries, immunization programs have decimated tetanus infections . However it does happen among non immunized and in rare cases immunized individuals as seen in this case report. Patients in developing countries present with unambiguous symptoms like risus sardonicus and opisthotonus. Therefore the diagnosis of tetanus remains a diagnostic challenge as the classical symptoms maybe absent at the time of presentation. It is important to recognize and immediately start critical care to prevent deterioration.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TETANUS, A RARE CONDITION WHICH ALSO CAN HAPPEN IN IMMUNIZED INDIVIDUALS

Shonita,Das1 , Zuriyah Ariffin2

 

 Hospital Tengku Ampuan Rahimah, Kuala Lumpur Malaysia

 

 

Introduction

There is a low incidence of tetanus in developed countries as most people are fully immunized. However there are rare occasions of tetanus which can result in life threatening muscle spasm with respiratory insufficiency or autonomic dysfunction.Thus early recognition and treatment is required,

 

Case report

 

A 26 year old malay male fully immunized presented to emergency department with right sided involuntary painful spasms 6 days ago whereby IM ATT was given. Patient had come to Emergency multiple times and was discharged with painkillers. Initially there was a diagnostic dilemma until the episode was captured in a video. He was then admitted to the intensive care unit whereby IM antitetanus Immunoglobulin together with antibiotics was given and wound debridement for the right knee was done. Subsequently patients spasms reduced and patient was eventually discharged.

 

Discussion & Conclusion

 

In developed countries, immunization programs have decimated tetanus infections . However it does happen among non immunized and in rare cases immunized individuals as seen in this case report. Patients in developing countries present with unambiguous symptoms like risus sardonicus and opisthotonus. Therefore the diagnosis of tetanus remains a diagnostic challenge as the classical symptoms maybe absent at the time of presentation. It is important to recognize and immediately start critical care to prevent deterioration.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TETANUS, A RARE CONDITION WHICH ALSO CAN HAPPEN IN IMMUNIZED INDIVIDUALS

Shonita,Das1 , Zuriyah Ariffin2

 

 Hospital Tengku Ampuan Rahimah, Kuala Lumpur Malaysia

 

 

Introduction

There is a low incidence of tetanus in developed countries as most people are fully immunized. However there are rare occasions of tetanus which can result in life threatening muscle spasm with respiratory insufficiency or autonomic dysfunction.Thus early recognition and treatment is required,

 

Case report

 

A 26 year old malay male fully immunized presented to emergency department with right sided involuntary painful spasms 6 days ago whereby IM ATT was given. Patient had come to Emergency multiple times and was discharged with painkillers. Initially there was a diagnostic dilemma until the episode was captured in a video. He was then admitted to the intensive care unit whereby IM antitetanus Immunoglobulin together with antibiotics was given and wound debridement for the right knee was done. Subsequently patients spasms reduced and patient was eventually discharged.

 

Discussion & Conclusion

 

In developed countries, immunization programs have decimated tetanus infections . However it does happen among non immunized and in rare cases immunized individuals as seen in this case report. Patients in developing countries present with unambiguous symptoms like risus sardonicus and opisthotonus. Therefore the diagnosis of tetanus remains a diagnostic challenge as the classical symptoms maybe absent at the time of presentation. It is important to recognize and immediately start critical care to prevent deterioration.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TETANUS, A RARE CONDITION WHICH ALSO CAN HAPPEN IN IMMUNIZED INDIVIDUALS

Shonita,Das1 , Zuriyah Ariffin2

 

 Hospital Tengku Ampuan Rahimah, Kuala Lumpur Malaysia

 

 

Introduction

There is a low incidence of tetanus in developed countries as most people are fully immunized. However there are rare occasions of tetanus which can result in life threatening muscle spasm with respiratory insufficiency or autonomic dysfunction.Thus early recognition and treatment is required,

 

Case report

 

A 26 year old malay male fully immunized presented to emergency department with right sided involuntary painful spasms 6 days ago whereby IM ATT was given. Patient had come to Emergency multiple times and was discharged with painkillers. Initially there was a diagnostic dilemma until the episode was captured in a video. He was then admitted to the intensive care unit whereby IM antitetanus Immunoglobulin together with antibiotics was given and wound debridement for the right knee was done. Subsequently patients spasms reduced and patient was eventually discharged.

 

Discussion & Conclusion

 

In developed countries, immunization programs have decimated tetanus infections . However it does happen among non immunized and in rare cases immunized individuals as seen in this case report. Patients in developing countries present with unambiguous symptoms like risus sardonicus and opisthotonus. Therefore the diagnosis of tetanus remains a diagnostic challenge as the classical symptoms maybe absent at the time of presentation. It is important to recognize and immediately start critical care to prevent deterioration.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TETANUS, A RARE CONDITION WHICH ALSO CAN HAPPEN IN IMMUNIZED INDIVIDUALS

Shonita,Das1 , Zuriyah Ariffin2

 

 Hospital Tengku Ampuan Rahimah, Kuala Lumpur Malaysia

 

 

Introduction

There is a low incidence of tetanus in developed countries as most people are fully immunized. However there are rare occasions of tetanus which can result in life threatening muscle spasm with respiratory insufficiency or autonomic dysfunction.Thus early recognition and treatment is required,

 

Case report

 

A 26 year old malay male fully immunized presented to emergency department with right sided involuntary painful spasms 6 days ago whereby IM ATT was given. Patient had come to Emergency multiple times and was discharged with painkillers. Initially there was a diagnostic dilemma until the episode was captured in a video. He was then admitted to the intensive care unit whereby IM antitetanus Immunoglobulin together with antibiotics was given and wound debridement for the right knee was done. Subsequently patients spasms reduced and patient was eventually discharged.

 

Discussion & Conclusion

 

In developed countries, immunization programs have decimated tetanus infections . However it does happen among non immunized and in rare cases immunized individuals as seen in this case report. Patients in developing countries present with unambiguous symptoms like risus sardonicus and opisthotonus. Therefore the diagnosis of tetanus remains a diagnostic challenge as the classical symptoms maybe absent at the time of presentation. It is important to recognize and immediately start critical care to prevent deterioration.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TETANUS, A RARE CONDITION WHICH ALSO CAN HAPPEN IN IMMUNIZED INDIVIDUALS

Shonita,Das1 , Zuriyah Ariffin2

 

 Hospital Tengku Ampuan Rahimah, Kuala Lumpur Malaysia

 

 

Introduction

There is a low incidence of tetanus in developed countries as most people are fully immunized. However there are rare occasions of tetanus which can result in life threatening muscle spasm with respiratory insufficiency or autonomic dysfunction.Thus early recognition and treatment is required,

 

Case report

 

A 26 year old malay male fully immunized presented to emergency department with right sided involuntary painful spasms 6 days ago whereby IM ATT was given. Patient had come to Emergency multiple times and was discharged with painkillers. Initially there was a diagnostic dilemma until the episode was captured in a video. He was then admitted to the intensive care unit whereby IM antitetanus Immunoglobulin together with antibiotics was given and wound debridement for the right knee was done. Subsequently patients spasms reduced and patient was eventually discharged.

 

Discussion & Conclusion

 

In developed countries, immunization programs have decimated tetanus infections . However it does happen among non immunized and in rare cases immunized individuals as seen in this case report. Patients in developing countries present with unambiguous symptoms like risus sardonicus and opisthotonus. Therefore the diagnosis of tetanus remains a diagnostic challenge as the classical symptoms maybe absent at the time of presentation. It is important to recognize and immediately start critical care to prevent deterioration.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 v

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Keywords

tetanus

References
Gulamhussein MA, Li Y, Guha A. Localized Tetanus in an Adult Patient: Case Report. Journal of Orthopaedic Case Reports. 2016;6(4):100-102. doi:10.13107/jocr.2250-0685.592.
Section
EMAS Meeting 2018 Abtracts