Citation

Nakagawa T, Suga H, Deguchi Y, Kimura T, Suzuki T. J. Tokyo Womens Med. Coll. 1999; 69(11): 694-701.

Copyright

(Copyright © 1999, Tokyo Women's Medical College)

DOI

unavailable

PMID

unavailable

Abstract

Tetanus is a nervous system disease caused by tetanospasmin, a toxin produced by Clostridium tetani. In Japan, tetanus, which occurs in association with even a slight injury, should always be taken into consideration in the traumatology field, although there are rare cases of tetanus owing to the spread of vaccination, etc. Treatment of spasm and sympathetic overactivity plays an important role in the therapeutic control of this disease. We had an experience of treating two patients suffering from severe tetanus with sympathetic overactivity. For one patient, it took about 15 days to control the disease by continuous administration of phenobarbital and diazepam. For the other patient, pancuronium bromide and midazolam were used and fentanyl citrate was added for circulatory dynamic stabilization, and control with a ventilator required about 28 days. Although both patients were cured from the tetanus and discharged, reduced myodynamia required rehabilitation, and delirium and suicide attempts required psychiatric treatment during the recovery period following the anti-spasm therapy. Careful systemic control of tetanus patients is necessary throughout the course of disease as complications to be watched may occur following the anti-spasm therapy as well, although the progress in respiratory control has contributed to the improvement in prognosis of tetanus patients.

Language: en

Keywords

adult; aged; antibiotic agent; antibiotic therapy; article; case report; cefazolin; cefbuperazone; cefoperazone; central nervous system infection; clostridium tetani; diazepam; disease course; emergency treatment; fentanyl citrate; gentamicin; human; male; midazolam; pancuronium bromide; phenobarbital; piperacillin; positive end expiratory pressure; sedation; tetanus; tetanus antibody; tetanus toxoid