Cephalic Tetanus

Maramattom, Boby Varkey; George, Abraham; Pa, Sathyapalan; Puthuran, Paul

doi:10.1385/ncc:4:3:258

Cited by 5 publications

(3 citation statements)

References 2 publications

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“…Few cases attributable to the head injury usually were secondary to small scalp lacerations of the frontal temporal regions as a result of minor trauma. Cases secondary to open depressed skull fracture, such as our case, are almost unknown [6][7][8][9][10][11][12][13][14][15][16][17][18][19]. A study from Ethiopia demonstrated that trauma to be the most common portal of entry in children.…”

Section: Discussionmentioning

confidence: 82%

Infected open depressed skull fracture complicated with tetanus grade I in an unimmunized child: a rare case report with literature review

et al. 2021

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Background Tetanus is a rare disease caused by Clostridium tetani, which produces tetanolysin and tetanospasmin. In 2018, there were only approximately ten tetanus cases reported in Indonesia. Despite widespread vaccination, especially in low–middle-income countries, tetanus still occurs (mostly in adults) due to the lack of immunization related to religious tenets, cultural belief, or inaccessibility to medical care. In addition, tetanus in the pediatric population shows features which are quite distinct from the adult group. Case presentation We report a case of a 7-year-old girl presented to our institution with a history of falling 10 days prior to admission, with only skin laceration on her forehead. For 1 day prior to admission, the patient looked drowsy and difficult to be awakened, accompanied with stiffness of her jaw; we diagnosed her as an unimmunized child with an open depressed skull fracture of her frontal bone and wound infection complicated with “lockjaw.” Perioperative management of this rare case is reported and discussed. Conclusion The pediatric intensive care of such patients requires halting further toxin production, neutralization of circulating toxin, and control of the clinical manifestation induced by the toxin that has already gained access to the central nervous system. The basic tenets of anesthetic care in such case must be well-managed and planned prior to surgery.

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Section: Discussionmentioning

confidence: 82%

Infected open depressed skull fracture complicated with tetanus grade I in an unimmunized child: a rare case report with literature review

et al. 2021

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“…Cases secondary to open depressed skull fracture, such as our case, are almost unknown. [5][6][7][8][9][10][11][12][13][14][15][16][17] Study from ethiopia showed us that trauma is the most common portal of entry in children as much as 79.2%. This can be explained by the high chance of ignoring pediatric trauma and lack of provision of tetanus prophylaxis.…”

Section: Discussionmentioning

confidence: 99%

Infected Open Depressed Skull Fracture Complicated with Tetanus Grade I in an Unimmunized Child: A Rare Case Report with Literature Review

Lukmanul

Faried

Nurhadiya

et al. 2020

Preprint

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Background: Tetanus is a rare disease caused by Clostridium tetani, which produces tetanolysin and tetanospasmin. In 2018, there were only approximately ten tetanus cases reported in Indonesia. Despite widespread vaccination, especially in low-middle income countries, tetanus still occurs (mostly in adult) due to the lack of immunization related to religious tenets, cultural belief or inaccesibility to medical care. In addition, tetanus in pediatric population shows features which are quite distinct from the adult group. Case Description: We reported a 7 year old girl that presented to our institution with a history of falling 10 days prior the admission, with only skin laceration of her forehead. Since one day prior to admission, the patient looked drowsy and difficult to be awakened, accompanied with stiffness of her jaw; we diagnosed as unimmunized child with open depressed skull fracture of her frontal bone and wound infection complicated with “lockjaw”. Perioperative management of that rare case is reported and discussed. Conclusion: This case is so exceptional, since the infected open depressed skull fracture complicated with trismus in an unimmunized child occurrence in our center is extremely rare; the pediatric intensive care of such patients requires halting further toxin production, neutralisation of circulating toxin and control of the clinical manifestation induced by the toxin that has already gained access to the central nervous system. The basic tents of anaesthetic care in such case had to well managed and planned prior the surgery.

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“…Cephalic tetanus is an uncommon variant, with an incidence of 1–3 per cent and a short incubation period of one to two days. Otitis media and head injury are frequently implicated 5 , 6 . The commonest presenting symptom is trismus with dysfunction of one or more cranial nerves, often the VIIth nerve, resulting in facial hemi-paresis and ptosis (Figure 1).…”

Section: Introductionmentioning

confidence: 99%