CDC , 2020. Tetanus: For Clinicians. Available at: https://www.cdc.gov/tetanus/clinicians.html. Accessed August 25, 2022.
Bae C , Bourge D , 2022. Tetanus. Treasure Island, FL, StatPearls Publishing.
European Centre for Disease Prevention and Control , 2022. Disease Factsheet about Tetanus. Available at: https://www.ecdc.europa.eu/en/tetanus/facts. Accessed March 10, 2023.
Lau LG , Kong KO , Chew PH , 2001. A ten-year retrospective study of tetanus at a general hospital in Malaysia. Singapore Med J 42: 346–350.
Malaysia Ministry of Health , 2022. Health Facts: Vaccine Preventable Diseases 2007–2021. Available at: https://www.moh.gov.my/moh/resources/Penerbitan/Penerbitan%20Utama/HEALTH%20FACTS/Health_Facts_2021.pdf. Accessed March 10, 2023.
Sodha VS , Gupta S , Bansal S , Yadav BL , Bharti D , Kaushik B , 2018. Study of clinico-epidemiological factors and outcome of tetanus in a tertiary care hospital. Int Surg J 5. doi: 10.18203/2349-2902.isj20182765.
Finkelstein P , Teisch L , Allen CJ , Ruiz G , 2017. Tetanus: a potential public health threat in times of disaster. Prehosp Disaster Med 32: 339–342.
Khan MAS et al., 2022. Factors associated with in-hospital mortality of adult tetanus patients—a multicenter study from Bangladesh. PLoS Negl Trop Dis 16: e0010235.
Nuwarda RF , Ramzan I , Weekes L , Kayser V , 2022. Vaccine hesitancy: contemporary issues and historical background. Vaccines (Basel) 10: 1595.
Qaderi S , Qaderi F , Tarki FE , Shah J , Afaghi S , Delsoz M , Shah A , 2021. Generalized, non-neonatial tetanus is a highly fatal disease in Afghanistan: a case series study. Int J Infect Dis 103: 568–572.
Faridah K , 2017. Immunisation Programme in Malaysia .Putrajaya, Malaysia: Disease Control Division, Ministry of Health Malaysia. Available at: https://www.fondation-merieux.org/wp-content/uploads/2017/10/vaccinology-2017-faridah-kusnin.pdf. Accessed March 10, 2023.
Chinchai T , Posuwan N , Vuthitanachot V , Wanlapakorn N , Poovorawan Y , 2019. Seroprevalence of an antibody against diphtheria, tetanus, and pertussis among the elderly in Khon Kaen, Thailand. J Health Popul Nutr 38: 28.
Collins S , White J , Ramsay M , Amirthalingam G , 2015. The importance of tetanus risk assessment during wound management. IDCases 2: 3–5.
Karnad DR , Gupta V , 2021. Intensive care management of severe tetanus. Indian J Crit Care Med 25: S155–S160.
Spruyt M , Van den Heever T , 2017. The treatment of autonomic dysfunction in tetanus. South Afr J Crit Care 33: 28–31.
Wasay M , Khealani BA , Talati N , Shamsi R , Syed NA , Salahuddin N , 2005. Autonomic nervous system dysfunction predicts poor prognosis in patients with mild to moderate tetanus. BMC Neurol 5: 2.
Sharma N , Li S , Sravanthi MV , Kazmierski D , Wang Y , Sharma A , Dhaubhadel P , 2021. Tetanus complicated by dysautonomia: a case report and review of management. Case Rep Crit Care 2021: 8842522.
Yen LM , Thwaites CL , 2019. Tetanus. Lancet 393: 1657–1668.
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Tetanus is a life-threatening infectious neurological condition that has become uncommon due to large-scale immunization campaigns. We describe a rare instance of generalized tetanus presenting with a headache on a tropical island in Malaysia. A 43-year-old woman presenting with headaches and generalized body weakness, which progressed into trismus and neck stiffness. Her medical history indicated a wound on the sole of her foot caused by shattered glass in an unhygienic area, but no tetanus prophylaxis had been administered. The patient was subsequently given immunoglobulin, tetanus toxoid, metronidazole, and sedatives in the recommended dosages. Her neurological condition improved remarkably, but she suffered blood pressure fluctuations due to dysautonomia. She was successfully discharged with complete recovery after 6 months of follow-up. The case demonstrates the significance of appropriate identification and care of tetanus, as well as the lethal effects of untreated wounds in vulnerable patients.
Authors’ addresses: Afiq Izzudin A. Rahim, Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia Health Campus, Kubang Kerian, Kelantan, Malaysia, and Langkawi Health District Office, Kompleks LADA, Kuah, Langkawi, Kedah, Malaysia, E-mail: afiqrahimusm@gmail.com. Emir Afif Mohammad Azlan, Communicable Disease Unit, Kedah Health State Department, Simpang Kuala, Jalan Kuala Kedah, Alor Setar, Kedah, Malaysia, E-mail: dremirafif@moh.gov.my. Muhamad Ruslan Rahman, Nafiisah Mahmud Pathi, and Mansor Ismail, Langkawi Health District Office, Kompleks LADA, Kuah, Langkawi, Kedah, Malaysia, E-mails: ruslanrahman@moh.gov.my, nafeesampt@gmail.com, and drmansor@moh.gov.my. Wan Aliaa Wan Sulaiman, Neurology Department, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia, E-mail: wanaliaa@upm.edu.my.
CDC , 2020. Tetanus: For Clinicians. Available at: https://www.cdc.gov/tetanus/clinicians.html. Accessed August 25, 2022.
Bae C , Bourge D , 2022. Tetanus. Treasure Island, FL, StatPearls Publishing.
European Centre for Disease Prevention and Control , 2022. Disease Factsheet about Tetanus. Available at: https://www.ecdc.europa.eu/en/tetanus/facts. Accessed March 10, 2023.
Lau LG , Kong KO , Chew PH , 2001. A ten-year retrospective study of tetanus at a general hospital in Malaysia. Singapore Med J 42: 346–350.
Malaysia Ministry of Health , 2022. Health Facts: Vaccine Preventable Diseases 2007–2021. Available at: https://www.moh.gov.my/moh/resources/Penerbitan/Penerbitan%20Utama/HEALTH%20FACTS/Health_Facts_2021.pdf. Accessed March 10, 2023.
Sodha VS , Gupta S , Bansal S , Yadav BL , Bharti D , Kaushik B , 2018. Study of clinico-epidemiological factors and outcome of tetanus in a tertiary care hospital. Int Surg J 5. doi: 10.18203/2349-2902.isj20182765.
Finkelstein P , Teisch L , Allen CJ , Ruiz G , 2017. Tetanus: a potential public health threat in times of disaster. Prehosp Disaster Med 32: 339–342.
Khan MAS et al., 2022. Factors associated with in-hospital mortality of adult tetanus patients—a multicenter study from Bangladesh. PLoS Negl Trop Dis 16: e0010235.
Nuwarda RF , Ramzan I , Weekes L , Kayser V , 2022. Vaccine hesitancy: contemporary issues and historical background. Vaccines (Basel) 10: 1595.
Qaderi S , Qaderi F , Tarki FE , Shah J , Afaghi S , Delsoz M , Shah A , 2021. Generalized, non-neonatial tetanus is a highly fatal disease in Afghanistan: a case series study. Int J Infect Dis 103: 568–572.
Faridah K , 2017. Immunisation Programme in Malaysia .Putrajaya, Malaysia: Disease Control Division, Ministry of Health Malaysia. Available at: https://www.fondation-merieux.org/wp-content/uploads/2017/10/vaccinology-2017-faridah-kusnin.pdf. Accessed March 10, 2023.
Chinchai T , Posuwan N , Vuthitanachot V , Wanlapakorn N , Poovorawan Y , 2019. Seroprevalence of an antibody against diphtheria, tetanus, and pertussis among the elderly in Khon Kaen, Thailand. J Health Popul Nutr 38: 28.
Collins S , White J , Ramsay M , Amirthalingam G , 2015. The importance of tetanus risk assessment during wound management. IDCases 2: 3–5.
Karnad DR , Gupta V , 2021. Intensive care management of severe tetanus. Indian J Crit Care Med 25: S155–S160.
Spruyt M , Van den Heever T , 2017. The treatment of autonomic dysfunction in tetanus. South Afr J Crit Care 33: 28–31.
Wasay M , Khealani BA , Talati N , Shamsi R , Syed NA , Salahuddin N , 2005. Autonomic nervous system dysfunction predicts poor prognosis in patients with mild to moderate tetanus. BMC Neurol 5: 2.
Sharma N , Li S , Sravanthi MV , Kazmierski D , Wang Y , Sharma A , Dhaubhadel P , 2021. Tetanus complicated by dysautonomia: a case report and review of management. Case Rep Crit Care 2021: 8842522.
Yen LM , Thwaites CL , 2019. Tetanus. Lancet 393: 1657–1668.
Past two years | Past Year | Past 30 Days | |
---|---|---|---|
Abstract Views | 3247 | 904 | 153 |
Full Text Views | 75 | 35 | 1 |
PDF Downloads | 94 | 39 | 1 |