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3.4.5 - Tetanus

from Section 3.4 - Neurological Impairment and Injury

Published online by Cambridge University Press:  27 July 2023

By
Sachin Mehta  and
Manpreet Bahra
Edited by
Ned Gilbert-Kawai ,
Debashish Dutta  and
Carl Waldmann
Ned Gilbert-Kawai
Affiliation:
The Royal Liverpool Hospital
Debashish Dutta
Affiliation:
Princess Alexandra Hospital NHS Trust, Harlow
Carl Waldmann
Affiliation:
Royal Berkshire Hospital, Reading
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Summary

Key Learning Points

  1. 1. Tetanus is a potentially lethal condition that must be considered in patients with muscle spasms and inadequate immunisation.

  2. 2. Initial management focuses on administration of human tetanus immunoglobulin, followed by wound cleaning and debridement.

  3. 3. Patients with shorter incubation periods have increased disease severity and mortality.

  4. 4. Supportive care is the mainstay of management to avoid complications such as fractures, rhabdomyolysis and respiratory failure.

  5. 5. Autonomic instability indicates severe disease and is the most common cause of death.

Keywords

tetanusClostridium tetanitetanospasmintetanus toxoid
Type
Chapter
Information
Intensive Care Medicine
The Essential Guide
 , pp. 191 - 193
Publisher: Cambridge University Press
Print publication year: 2021

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References

References and Further Reading

Ahmadsyah, I, Salim, A. Treatment of tetanus: an open study to compare the efficacy of procaine penicillin and metronidazole. Br Med J (Clin Res Ed) 1985;291:648.CrossRefGoogle ScholarPubMed
Rushdy, AA, White, JM, Ramsay, ME, Crowcroft, NS. Tetanus in England and Wales, 1984–2000. Epidemiol Infect 2003;130:71.CrossRefGoogle ScholarPubMed
Santos, ML, Mota-Miranda, A, Alves-Pereira, A, et al. Intrathecal baclofen for the treatment of tetanus. Clin Infect Dis 2004;38:321.CrossRefGoogle ScholarPubMed
Thwaites, CL, Farrar, JJ. Preventing and treating tetanus. BMJ 2003;326:117.CrossRefGoogle ScholarPubMed
Thwaites, CL, Yen, LM, Loan, HT, et al. Magnesium sulphate for treatment of severe tetanus: a randomised controlled trial. Lancet 2006;368:1436.CrossRefGoogle ScholarPubMed

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