부산대학교 도서관

Tetanus is an acute-onset disease that results from exposure to the exotoxins produced by Clostridium tetani. It is characterized by tonic muscle spasms and has high morbidity and mortality. Respiratory failure is the most severe problem causing mortality in generalized tetanus. Mechanical ventilation is almost always mandatory for tetanus patients with respiratory failure and airway obstruction. Here, we report a 60-year-old man with generalized tetanus. He was admitted to the emergency department with jaw stiffness, dysphagia, breathlessness, and fever. His history revealed that he had suffered an injury to his left toe by a rusted nail seven days ago. He had received one dose of tetanus vaccine but no anti-tetanus immunoglobulin was given. He also did not know his prior vaccination history. He was diagnosed as tetanus and was followed up in the intensive care unit. He was treated with intravenous metronidazole and 60.000 IU equine tetanus antiserum. Midazolam was given for generalized muscle spasms. He was put on mechanical ventilation for 11 days and was discharged from the hospital 28 days after admission with recovery. In conclusion, although tetanus is now rare for our country, it should not be forgotten. Prior vaccination should be queried in patients who are admitted to hospitals with injury, and they should be accurately evaluated for vaccination and immunoglobulin.