Tetanus in Finland: Diagnostic Problems and Complications

Luisto, Marjaana

doi:10.3109/07853899009147234

Cited by 10 publications

(10 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The association of so called milder forms i.e. stages I and II on Ablett's criteria [3] to ANS dysfunction and its affect on outcome is not well established. Our study highlights the importance of this previously not well-known aspect of tetanus.…”

Section: Introductionmentioning

confidence: 99%

Autonomic nervous system dysfunction predicts poor prognosis in patients with mild to moderate tetanus

et al. 2005

View full text Add to dashboard Cite

BackgroundAutonomic nervous system (ANS) dysfunction is present in up to one third of patients with tetanus. The prognostic value of ANS dysfunction is known in severe tetanus but its value is not well established in mild to moderate tetanus.MethodsMedical records of all patients admitted with tetanus at two academic tertiary care centers in Karachi, Pakistan were reviewed. The demographic, clinical and laboratory data was recorded and analyzed. ANS dysfunction was defined as presence of labile or persistent hypertension or hypotension and sinus tachycardia, tachyarrythmia or bradycardia on EKG. Patients were divided into two groups based on presence of ANS dysfunction (ANS group and non ANS group). Tetanus severity was classified on the basis of Ablett criteria.ResultsNinety six (64 males; 32 females) patients were admitted with the diagnosis over a period of 10 years. ANS group had 31 (32%) patients while non ANS group comprised of 65 (68%) patients. Both groups matched for age, gender, symptom severity, use of tetanus immunoglobulin and antibiotics. Twelve patients in ANS group had mild to moderate tetanus (Ablett I and II) and 19 patients had severe/very severe tetanus (Ablett III and IV). Fifteen (50%) patients in ANS group required ventilation as compared to 28 (45%) in non-ANS group (p = 0.09). Fourteen (47%) patients died in ANS group as compared to 10 (15%) in non ANS group (p= 0.002). Out of those 14 patients died in ANS group, six patients had mild to moderate tetanus and eight patients had severe/ very severe tetanus. Major cause of death was cardiac arrhythmias (13/14; 93%) in ANS group and respiratory arrest (7/10; 70%) in non ANS group. Ten (33%) patients had complete recovery in ANS group while in non ANS group 35(48%) patients had complete recovery (p= 0.05).ConclusionsANS dysfunction was present in one third of our tetanus population. 40% patients with ANS dysfunction had only mild to moderate tetanus. ANS dysfunction, irrespective of the need of mechanical ventilation or severity of tetanus, predicted poor outcome.

show abstract

Section: Introductionmentioning

confidence: 99%

Autonomic nervous system dysfunction predicts poor prognosis in patients with mild to moderate tetanus

et al. 2005

View full text Add to dashboard Cite

show abstract

“…2,16 It was shown that tetanus had been diagnosed on the first visit to a doctor in only half of the patients, suspected in 28% and not considered in 22%. 4 The main problems are difficulty of early diagnosis and treatment of severe complications. There is a need for prompt diagnosis and treatment because of the risk of respiratory failure.…”

Section: Discussionmentioning

confidence: 99%

“…3 The main problem facing emergency physicians is the difficulty in early diagnosis of this uncommon disease. 4,5 This is the report of a case of tetanus with subtle initial presentation.…”

Section: Introductionmentioning

confidence: 99%

An Intravenous Drug Addict Presenting with ‘Shortness of Breath’: Case Report

Chung¹

2004

Hong Kong Journal of Emergency Medicine

View full text Add to dashboard Cite

A 49-year-old male intravenous drug addict attended the emergency department complaining of 'shortness of breath' for one day. He was discharged after evaluation and referred to the methadone clinic. He reattended the next day complaining of neck stiffness and twitching of limbs for one day. The final diagnosis was tetanus. Although tetanus is rare in Hong Kong, high vigilance should still be maintained for its atypical presentations, especially in high-risk groups.

show abstract

“…The diagnosis of tetanus is likely to be delayed if a patient is elderly or has no known primary lesion 3 . The worst prognosis occurs in infants, the elderly, smokers and those with grossly contaminated wounds and a short period of onset of symptoms.…”

Section: Discussionmentioning

confidence: 99%