Ear Piercing: A Gateway to Tetanus

Abstract

Tetanus is initiated by the release of neurotoxins. The progressive paralysis of several muscles is due to contamination of the wound by the toxin. The case under discussion was about a patient with the tetanus infection after ear piercing due to unsterilized instruments and lack of awareness of complications. Due to the late presentation to the hospital, leading to a delay in treatment, the child could not survive. Physicians need to have a vigilant eye to have a high suspicion for tetanus at a very early stage and immediate initiation of advanced critical care, which can favour lifesaving interventions. Prophylactic tetanus toxoid should be administered before any body piercing

Tetanus; a dreadful complication of ear piercing, ear instrumentation and chronic otorrhea in children of Southern Punjab Pakistan.

“…In chronic otorrhea, fingering and inserting contaminated objects into ears are postulated mechanisms of spreading Clostridium tetani to the affected individuals. 5,6,7,12 Poor tetanus vaccination / immunization of population during childhood render these children vulnerable to develop tetanus following piercing, instrumentation and chronic ear infection. This destitute state of tetanus vaccination/immunization is attributed to lack of awareness, illiteracy, decreased uptake by people, false beliefs, religious refusals, fears of injections/syringes, side effects, etc.…”

“…Unhygienic ear piercing not only predisposes to various dreadful complications including perichondritis, chondritis, sepsis, cavernous sinus thrombosis but also tetanus. 7,8 Impacted cerumen and chronic otitis media are common causes of hearing impairment in children. 9,10 In our setup, many people take children to quacks for ear cleansing / instrumentation for common otorhinological conditions including impacted cerumen and chronic otitis media.…”

“…As already emphasized, unhygienic conditions and unsterilized instruments can cause various complications including tetanus. 7 Tetanus has been seen in chronic discharging ears where Clostridium microorganisms are thought to secondarily infect after contamination with dirty fingers, objects inserted into ears and ear cleansing/instrumentation. 5,6 The study has been carried out to study the pediatric cases of tetanus developing after unhygienic ear piercing and cleaning/ instrumentation.…”

Emotional and Behavioral Problems in Children With Hearing Impairment

“…Findings of one of the studies conducted in one region of Pakistan revealed 7.9% prevalence rate of hearing impairment in school children (Elahi et al, 1998). Mumtaz and Habibullah (2017) found that late identification of the deficits in hearing in children is a common practice in least developed countries, including Pakistan as the absence of neonatal hearing screening is one of the major causes. Findings also revealed that a significant number of the cases of mild hearing loss i.e., 26%, may be missed even if neonatal screening facility is the present (Walker et al, 2017).…”