Tetanus in the Elderly: The Management of Intensive Care and Prolonged Hospitalization

Abstract

Tetanus is a potentially fatal infection. Approximately 100 cases are reported in Japan each year; however, little is known about its clinical course and outcomes in the current era of treatment. We herein report three cases of tetanus in elderly patients who survived after mechanical ventilation and intensive care. These patients, together with six other similar cases, had a median weaning period of 31 days and median length of stay of 77 days. In elderly patients, severe systemic forms of tetanus require prolonged mechanical ventilation and hospitalization. To improve prevention, tetanus vaccination should be promoted more aggressively among those who are susceptible to the disease.

Tetanus in the elderly: the neglected killer

“…There are many cases of tetanus reported in the elderly, worldwide [6,7,8]. However, in Sri Lanka, case reports of tetanus are lacking, due to the low incidence of tetanus as a result of the successful immunization programme and other preventive measures.…”

Tetanus without apparent history of trauma

“…However, the incidence of tetanus in developed countries is very low, at approximately 0.2 cases per million population, because tetanus toxoid was introduced into the routine childhood immunization schedule. The incidence of tetanus in Japan is still higher than other developed countries: about 100 cases per year (0.9 cases per million populations) …”