Tracheostomy and tetanus

Healthcare-associated pneumonia (HCAP) is a common complication in patients with severe tetanus. Nursing tetanus patients in a semi-recumbent body position could reduce the incidence of HCAP. In a randomised controlled trial we compared the occurrence of HCAP in patients with severe tetanus nursed in a semi-recumbent (30°) or supine position. A total of 229 adults and children (aged ≥1 year) with severe tetanus admitted to hospital in Vietnam, were randomly assigned to a supine (n=112) or semi-recumbent (n=117) position...

BACKGROUND: Tetanus is still a major health problem in developing countries and it is associated with a high morbidity and mortality rate. There is paucity of published data regarding the management of tetanus in Tanzania, especially the study area. This study was conducted to describe our own experiences with tetanus outlining the clinical characteristics and treatment outcome of tetanus patients in our environment and to identify predictors of outcome of these patients. METHODS: This was a ten-year period retrospective study of patients who presented with a clinical diagnosis of tetanus at Bugando Medical Centre between January 2001 and December 2010...

BACKGROUND: Tetanus remains a major health problem in Ethiopia like in most other developing countries. OBJECTIVES: To assess the clinical presentation, complications and outcome of tetanus patients. METHODS: In this retrospective study, patients (age > 13 years) who were admitted to Jimma University Teaching Hospital from 1996 to 2009 were included. RESULTS: Data from 171 patients were analyzed (129 males, 42 females, mean age 33 years)...

OBJECTIVES: Severe tetanus is one of the indications for admissions into the intensive care unit requiring muscular paralysis, tracheostomy and mechanical ventilatory support. This study aimed to evaluate tetanus patients managed with tracheostomy and to determine associated complications. METHODS: This was a 16-year review of patients who were managed for tetanus with tracheostomy in an intensive care unit between 1999 and 2009. The data collected from the medical records including demographic data, clinical presentations, tetanus immunization history, suspected portal entry of infection, duration of ICU admission, endotracheal intubation, tracheostomy, and complications...

BACKGROUND: Tetanus is a life threatening disease. Reported mortality for tetanus is 15-39%. Conventional treatment includes heavy sedation and artificial ventilation. Complications resulting from long term heavy sedation and artificial ventilation contribute to 60% of the total mortality caused by tetanus. In this study magnesium sulphate was used to reduce the need for sedation and artificial ventilation. Objectives of this prospective study were to determine the role of magnesium sulphate in post traumatic tetanus...

INTRODUCTION: Tetanus rarely occurs in developed countries, but it can result in fatal complications including respiratory failure due to generalized muscle spasms. Magnesium infusion has been used to treat spasticity in tetanus, and its effectiveness is supported by several case reports and a recent randomized controlled trial. CASE PRESENTATIONS: Three Caucasian Greek men aged 30, 50 and 77 years old were diagnosed with tetanus and admitted to a general 12-bed intensive care unit in 2006 and 2007 for respiratory failure due to generalized spasticity...

AIM: To analyse demography, clinical presentation, treatment, complications and outcome of patients with tetanus over a 2-year period. MATERIALS AND METHODS: A retrospective analysis of medical records of all patients with tetanus admitted to the intensive care unit of B.P Koirala Institute of Health Sciences, Dharan, Nepal between July 2004 and June 2006. RESULTS: Tetanus accounted for 1.1 % of our ICU admission. Eight tetanus patients (mean age 52 years; M: F ratio 7:1) were admitted...

BACKGROUND: Tetanus is a fatal infection caused by the neurotoxin tetanospasmin released by the vegetative spores of Clostridium tetani. The high mortality rate is related to frequent tetanic fits with laryngeal spasm and airway obstruction. Numerous anticonvulsants are in use, with varying efficacy in controlling fits. This case report highlights the use of ketamine as adjunctive therapy in the management of tetanus. CASE REPORT: A 20-year-old woman was admitted with a history of recurrent left ear pain, with bloody, purulent discharge, following a self-inflicted injury...

BACKGROUND: The most common cause of death in individuals with severe tetanus in the absence of mechanical ventilation is spasm-related respiratory failure, whereas in ventilated patients it is tetanus-associated autonomic dysfunction. Our aim was to determine whether continuous magnesium sulphate infusion reduces the need for mechanical ventilation and improves control of muscle spasms and autonomic instability. METHODS: We did a randomised, double blind, placebo controlled trial in 256 Vietnamese patients over age 15 years with severe tetanus admitted to the Hospital for Tropical Medicine, Ho Chi Minh City, Vietnam...

No abstract text is available yet for this article.

BACKGROUND: Rattlesnake envenomation of New World camelids is a seasonal problem with often dramatic clinical signs. HYPOTHESIS: The purpose of this study was to identify the clinical signs, laboratory results, treatment methods, and outcome for rattlesnake envenomation in New World camelids. ANIMALS: Medical records from 1988 to 2004 were searched for New World camelids presented for rattlesnake bite or clinical signs suspected to be related to recent envenomation...

Patients with tetanus complaining of common signs such as lockjaw, voice disturbance, and difficulty in swallowing, etc, should never be forgotten. A 71-year old woman complained of dyspnea and difficulty in swallowing. She had lockjaw with tongue bite soon after a tracheostomy, and she was diagnosed as having tetanus. She showed the redundant gag reflex even to a slight stimulus and limited mobility of bilateral vocal cords, which improved following intravenous administration of diazepam. This case suggests that the mobility of the vocal cords and the movement of the larynx could be limited in tetanus because even a slight stimulus caused a strong gag reflex, resulting in dyspnea or difficulty in swallowing...

Unvaccinated individuals throughout the world are vulnerable to tetanus, but there are few data regarding the impact of focused vaccination programmes and modern intensive care facilities on the disease, particularly in the developing world. The Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam admitted 2422 patients with tetanus aged > or =1 year between April 1993 and December 2002, during which time vaccine coverage and treatment facilities improved. The proportion of children < or =10 years old admitted with tetanus fell from 11...

Penicillin, the drug of choice in tetanus, may potentiate the effect of tetanus toxin by inhibiting the type-A (GABAA) receptor for gamma-amino-n-butyric acid. Metronidazole has therefore been suggested as an alternative. Intramuscular benzathine penicillin (1.2 million units as a single dose; N=56), enteral metronidazole (600 mg every 6 h for 10 days; N=55) and intravenous benzyl penicillin (2 million units every 4 h for 10 days; N=50) were therefore compared, in a randomized, controlled trial, among patients with all grades of tetanus...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.