Perioperative care of a child with tetanus

Schloss, Brian; Cambier, Gregory S; Tobias, Joseph D.

doi:10.1080/22201173.2011.10872810

Cited by 3 publications

(3 citation statements)

References 33 publications

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“…Various intravenous and inhalation anaesthetic agents have been used without incidence in tetanus patients. 24 In our case, there are several risk factor related to tetanus complications. Firstly, she never received any vaccination and the wound is not properly taken care of, moreover she did not get immunoglobulin to neutralize the toxin after the accident.…”

Section: Discussionmentioning

confidence: 57%

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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Section: Discussionmentioning

confidence: 57%

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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show abstract

“…Preparation for a potentially difficult airway was in place, and spontaneous ventilation was maintained by the induction of anesthesia with sevoflurane in 100% O 2 . Various intravenous and inhalation anesthetic agents have been used without incidence in tetanus patients [ 25 ]. In our case, there were several risk factors related to tetanus complications.…”

Section: Discussionmentioning

confidence: 99%

“…Although uncommon, with prolonged tetanus, associated cardiomyopathy repeated exposure to catecholamines may be present. A perioperative assessment of renal and electrolyte balance required the presence of myoglobinuria and renal dysfunction [ 21 , 25 ]. In our case, 3 weeks postoperative course was uneventful, and the patient showed an excellent clinical recovery and discharged on postoperative day 16.…”

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

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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Updates on tetanus toxin: A fundamental approach

Ahaduzzaman¹

2015

J Adv Vet Anim Res

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Perioperative care of a child with tetanus

Cited by 3 publications

References 33 publications

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

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

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

Updates on tetanus toxin: A fundamental approach

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