An unexpected tetanus case

Onder Ergonul*, Demet Egeli, Bulent Kahyaoglu, Mois Bahar, Mill Etienne, Thomas P Bleck

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

35 Scopus citations

Abstract

1 million cases of tetanus are estimated to occur worldwide each year, with more than 200 000 deaths. Tetanus is a life-threatening but preventable disease caused by a toxin produced by Clostridium tetani—a Gram-positive bacillus found in high concentrations in soil and animal excrement. Tetanus is almost completely preventable by active immunisation, but very rarely unexpected cases can occur in individuals who have been previously vaccinated. We report a case of generalised tetanus in a 22-year-old woman that arose despite the protective antitoxin antibody in her serum. The patient received all her vaccinations in the USA; her last vaccination was 6 years ago. The case was unusual because the patient had received all standard vaccinations, had no defined port of entry at disease onset, and had symptoms lasting for 6 months. Tetanus can present with unusual clinical forms; therefore, the diagnosis and management of this rare but difficult disease should be updated. In this Grand Round, we review the clinical features, epidemiology, treatment, and prognosis of C tetani infections.

Original languageEnglish (US)
Pages (from-to)746-752
Number of pages7
JournalThe Lancet Infectious Diseases
Volume16
Issue number6
DOIs
StatePublished - Jun 1 2016

ASJC Scopus subject areas

  • Infectious Diseases

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