Does diabetes put you at risk of tetanus?

Abstract

This 81-year-old man with a history of type 2 diabetes presented with a cramping right arm, trismus, stiffness in the jaw, swallowing and breathing difficulties. He developed respiratory failure shortly after admission so was intubated on the intensive therapy unit where he received tetanus immunoglobulin and a course of metronidazole. Kilic et al. compared the level of tetanus antitoxin between patients with type 2 diabetes and healthy controls. They found a statistically significant difference between the groups, with people with diabetes having lower antitoxin levels. A further study shows that serum levels of tetanus antibody significantly decrease in diabetic patients older than 50 years of age. Among patients with diabetes only 55.9% had protective levels of antitoxin when aged 50-64 compared to 73.8% of controls. Copyright © 2010 John Wiley & Sons. Copyright © 2010 John Wiley & Sons, Ltd

Neurologic infections in diabetes mellitus

“…Infection does not develop in all diabetic foot ulcers; patients should be assessed for infection based on local evidence of inflammation (pain or tenderness, swelling or induration, warmth, erythema) as well systemic signs such as fever or manifestations of sepsis . Passive national surveillance from 2001 to 2008 in the US found that 15% of patients diagnosed with tetanus also had DM, triple the rate of the general population over that period (Centers for Disease Control and Prevention, 2011), indicating a need for more intensive attention to tetanus toxoid vaccination status in patients with DM (Soulsby and Russell-Jones, 2010). The prevalence of MRSA in diabetic foot infections ranges from 5% to 30% and continues to rise, complicating selection of empiric antibiotic coverage.…”