Tetanus: Still a Threat: Clinical Case Report

Abstract

Tetanus is a potentially fatal disease, preventable through vaccination, caused by neurotoxins produced by Clostridium tetani, which cease inhibitory neurotransmission. It presents a symptomatic triad: stiffness, muscular spasms and autonomic dysfunction. The therapeutic approach is essentially symptomatic, including wound cleaning, benzodiazepines, neuromuscular blockade, ventilatory support and antibiotic therapy. We present the clinical case of a 79-year-old female patient, with outdated tetanus vaccine, admitted in the context of an injury to the left wrist, without prophylaxis with tetanus immunoglobulin. Reassessed in the emergency 5 days after the event with trismus, opisthotonos, respiratory failure and dysautonomia. We proceeded to wound cleaning, immunoglobulin and antibiotic therapy administration, sedation, ventilatory support and we transferred the patient to an intensive care unit. It was a case without prophylaxis, showing that tetanus is still a threat that should alert us all to the immunological situation and compli- ance with the national vaccination plan.