Recurrent tetanus in diagnosed breast cancer patients of the Philippine General Hospital

Bautista, Jesi Ellen Cueto; Shu, Leah L. Shiong; Pascual, Jose Leonard R.; Pasco, Paul Matthew D.

doi:10.1016/j.jns.2013.07.2062

Cited by 2 publications

(4 citation statements)

References 13 publications

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“…However, as tetanus is prone to recurrence, the acquisition of active immunity is essential to prevent recurrence after remission. Multiple doses of vaccination may be required to ensure adequate antibody titers and immunity to tetanus are achieved in cancer patients [ 17 , 25 – 27 ].…”

Section: Discussionmentioning

confidence: 99%

“…Recent studies have reported 15 cases of tetanus in patients with breast cancer skin ulcer (Table 1) [4][5][6][7][8][9][10][11][12][13][14][15][16][17]. Twelve of these cases (A-L) underwent surgical debridement.…”

Section: Discussionmentioning

confidence: 99%

“…Patients with chronic wounds such as skin ulcer are at a high risk of tetanus as these wounds provide an entry route for tetanus bacteria [3]. In fact, previous studies have shown that patients with skin ulcer due to advanced breast cancer are at a particularly high risk of developing tetanus and that removing the ulcer is the only effective treatment in such cases [4][5][6][7][8][9][10][11][12][13][14][15][16][17]. A cancerous skin ulcer contains necrotic tissue, which constitutes anaerobic environment that is conducive to the growth of tetanus bacteria and the production of toxins [3,18,19].…”

Section: Introductionmentioning

confidence: 99%

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Non-surgical treatment of tetanus infection associated with breast cancer skin ulcer: a case report and literature review

Nomura

Sakawaki

et al. 2021

BMC Infect Dis

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Background Previous studies have reported poor prognosis in cases of tetanus that develops after bacteria enters via breast cancer-related skin ulcers that are not treated with surgical debridement. Herein, we review the literature concerning this presentation and report the first case of complete remission from tetanus without surgical debridement of the skin ulcer. Case presentation An Asian woman aged over 60 years had a history of skin ulcer caused by breast cancer. She was diagnosed with tetanus due to trismus and opisthotonus. Based on the suspicion that the skin ulcer was the portal of entry for tetanus bacteria, we considered several debridement and thoracic surgical options for tetanus treatment. However, debridement was not performed as the surgery was considered high risk and the patient did not consent to it. The patient received treatment with anti-tetanus globulin and metronidazole; sound insulation and shielding were also performed in a dark room. Subsequently, the patient’s symptoms improved, and sound insulation and deep sedation management were completed on 19th day of hospitalization. With no symptom recurrence, the patient was discharged on Day 54. To date, over 3 years after treatment, no evidence of tetanus recurrence has been observed. The case was characterized by a lack of autonomic hyperactivity. The tetanus severity was likely representative of the low amount of toxin that the patient was exposed to. Conclusion This case involved moderate severity tetanus originating from a chronic skin ulcer related to breast cancer. The patient survived without undergoing extensive debridement. No evidence of tetanus relapse was observed during the follow-up period, likely due to vaccination that might have restored the patient’s active immunity. Debridement is not always necessary for tetanus complicated by breast cancer skin ulcers. Furthermore, appropriate toxoid vaccination is critical for preventing the onset and recurrence of tetanus in these patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Non-surgical treatment of tetanus infection associated with breast cancer skin ulcer: a case report and literature review

Nomura

Sakawaki

et al. 2021

BMC Infect Dis

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“…It is an endemic infection especially in the developing countries largely due to inadequate vaccination uptake (1) poor T environmental sanitation (2), suboptimal storage facilities for vaccines, ignorance and harmful cultural practices (3). Cancer patients are particularly vulnerable to tetanus infection because of immuno-compromised state, advance age, chronic psychological stress and use of immunosuppressive drugs (2,4). In this case, we report a fatal case of generalized tetanus following use of topical traditional medication on a fungating breast cancer.…”

mentioning

confidence: 92%

A Rare Case of Generalized Tetanus Complicating Breast Cancer: A Consequence of Harmful Cultural Practices.

Waziri¹,

Adeiza²,

Toli³

et al. 2021

ABMS

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Tetanus infection is a public health disease and is still a cause of high morbidity and mortality in developing countries compared to the developed countries of the world. Apart from the traditional risk factors for tetanus, ignorance and harmful cultural practices greatly increase the risk and poor outcomes of tetanus in our country. We report this case of fatal generalized tetanus infection from necrotic fungating tumour following application of traditional herbal medication to highlight the link between a non-communicable disease, an infectious disease and poor health seeking behaviour in a global health context. We also reviewed similar cases reported in the literature. Patient consent was sought for before her death and patient confidentiality was assured.

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Recurrent tetanus in diagnosed breast cancer patients of the Philippine General Hospital

Cited by 2 publications

References 13 publications

Non-surgical treatment of tetanus infection associated with breast cancer skin ulcer: a case report and literature review

Non-surgical treatment of tetanus infection associated with breast cancer skin ulcer: a case report and literature review

A Rare Case of Generalized Tetanus Complicating Breast Cancer: A Consequence of Harmful Cultural Practices.

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