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Vol. 159. Issue 3.
Pages 147-151 (August 2022)
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Vol. 159. Issue 3.
Pages 147-151 (August 2022)
Clinical report
Tetanus, analysis of 29 cases
Tétanos, análisis de 29 casos
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Alexandre Pérez-Gonzáleza,b,
Corresponding author
, Isabel Fernández-Castrob, Alejandro Araújo-Ameijeirasa, Judith Álvarez-Oteroc, Antonio Ocampob, Javier de la Fuentec
a Group of Virology and Pathogenesis, Galicia Sur Health Research Institute, Vigo, Spain
b Internal Medicine Department, Alvaro Cunqueiro Hospital, Vigo, Spain
c Internal Medicine Department, Ribera Povisa Hospital, Vigo, Spain
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Abstract
Background

Tetanus disease is caused by Clostridium tetani, an anaerobe bacteria found in dust and soil. Once reached human body through damaged tissues, C. tetani releases several neurotoxins which block the inhibitory function, leading to an increased muscle tone, ultimately causing respiratory failure. Severe tetanus is a life-threatening disease, especially in low-income-regions.

Methods

This is a retrospective case-series study, undertaken at two hospitals of Vigo (population area 600,000 inhabitants). Tetanus cases were identified through the discharge databases of both hospitals between the years 1995–2019. Epidemiological and clinical data were obtained from the patient's medical records.

Results

A total of 33 cases were identified; median age was 67 years, and most of patients were women (n=16, 55.2%). Generalized tetanus was the most common clinical course, and neck stiffness was the most frequent symptom. A total of 25 patients (86%) were admitted to the Intensive Care Unit, 21 required invasive ventilation and 2 patients died.

Discussion

The incidence of tetanus was low but most of cases were severe. Mortality was slightly higher than previously reported. Interestingly, the deceased patients were old-women, consistent with previously reported research in high-income-regions, while mortality in low-income-countries concentrates in middle-aged men.

Keywords:
Tetanus
Clostridium tetani
Tetanus toxoid
Tetanus vaccine
Resumen
Introducción

El tétanos es causado por Clostridium tetani, bacteria anaerobia, ubicada en el suelo. Este microorganismo penetra a través de heridas y libera neurotoxinas que bloquean la función inhibitoria, produciendo espasticidad y fracaso respiratorio. Es una enfermedad grave, especialmente en regiones empobrecidas.

Métodos

Serie de casos realizada en dos hospitales vigueses (área 600.000 habitantes). Los casos fueron identificados mediante los sistemas de codificación entre 1995-2019. Los datos asistenciales se obtuvieron de la historia clínica.

Resultados

Se identificaron 33 casos, mediana de edad, 67 años, la mayoría mujeres (n = 16, 55,2%). El tétanos generalizado fue la forma clínica predominante, la rigidez cervical el síntoma más común. Un total de 25 pacientes requirieron ingreso en UCI, 21 ventilación mecánica, dos fallecieron.

Discusión

El número de casos fue bajo, pero la mayoría graves. La mortalidad fue ligeramente superior a la informada previamente. La mortalidad se concentró en mujeres ancianas, concordante con otros países desarrollados, mientras que la mortalidad en regiones no-desarrolladas se agrupa en varones de mediana edad.

Palabras clave:
Tétanos
Clostridium tetani
Toxoide tetánico
Vacuna antitetánica

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