Rhabdomyolysis secondary to Tetanus Toxoid administration in a Patient Following Minor Laceration

Causality of rhabdomyolysis and combined tetanus, diphtheria and acellular pertussis (Tdap) vaccine administration

“…The most common adverse reactions within 14 days following Adacel vaccine include injection site pain (62.9% to 77.8%), erythema, and swelling as well as headache (33.9-43.7%), body ache or muscle weakness (21.9-30.4%), tiredness (24.3-30.2%), chills (8.1-15.1%), sore and swollen joints (9.1-11.3%), and fever. 9 Moderate (interfered with activities, but did not necessitate medical care or absenteeism) body ache or muscle weakness is reported with Tdap vaccination in adolescents and adults in 8.5% and 6.1% respectively. Whilst severe (incapacitating, prevented the performance of usual activities, may have/or did necessitate medical care or absenteeism) body ache or muscle weakness is reported in 1.2% and 1.3% of adults and adolescents respectively.…”

“…Adacel is combined inactive vaccine containing tetanus toxoid, diphtheria toxoid, and acellular pertussis. The most common adverse reactions within 14 days following Adacel vaccine include injection site pain (62.9% to 77.8%), erythema, and swelling as well as headache (33.9–43.7%), body ache or muscle weakness (21.9–30.4%), tiredness (24.3–30.2%), chills (8.1–15.1%), sore and swollen joints (9.1–11.3%), and fever . Moderate (interfered with activities, but did not necessitate medical care or absenteeism) body ache or muscle weakness is reported with Tdap vaccination in adolescents and adults in 8.5% and 6.1% respectively.…”

“…In order to prevent pertussis in older populations, to reduce the potential for transmission from older individuals to susceptible infants, current recommendations are for routine immunization of adolescents, adults using reduced antigen content acellular pertussis‐containing (Tdap) vaccines . Although myalgia is common following vaccination, severe rhabdomyolysis (secondary to vaccinations alone) has only rarely been reported …”

“…[1][2][3] Although myalgia is common following vaccination, severe rhabdomyolysis (secondary to vaccinations alone) has only rarely been reported. [4][5][6][7][8][9][10][11] Here, we report for the first time a case of rhabdomyolysis with a very high serum creatine kinase (CK) associated with vaccination with a combined diphtheria, tetanus, and acellular pertussis (Tdap) vaccine in a patient without any other risk factors for muscle injury. An objective drug causality assessment using the Naranjo scale indicates that the rhabdomyolysis was "probable" (Score 5) causation by the Tdap vaccine.…”

Diretrizes para o manejo do tétano acidental em pacientes adultos

“…(100) Elevations in muscle enzymes have been reported even after tetanus toxoid administration, (101) and CPK levels may be quite high (above 22,000). (102) Acute kidney injury is frequent in tetanus patients and is associated with increased mortality. Although sparse reports are available on the development of renal failure in tetanus patients, in patients with moderate CPK increases (around 6,000 U/L), (103) rhabdomyolysis as cause of acute kidney injury is not common.…”