Unpredictable complications of tetanus

The Central Hospital for Tropical Diseases has just promptly treated a male patient with tetanus without any signs of injury or scratches on his body.

Male patient LV S, 65 years old in Hai Duong , had a history of good health, without any signs of injury or scratches on the body.

However, 10 days before admission, the patient began to have symptoms of sore throat but no fever. When he visited the medical facility, the patient was diagnosed with acute pharyngitis and was prescribed medication for outpatient treatment.

After 6 days of using the medicine, the patient developed unusual symptoms such as difficulty opening his mouth, difficulty speaking and poor eating. Realizing the symptoms were getting worse, the family took the patient to a medical facility. Here, he was diagnosed with tetanus and transferred to the Central Hospital for Tropical Diseases.

At the Emergency Department of the Central Hospital for Tropical Diseases, the patient's initial condition was quite alert, no fever, no convulsions, but the ability to open the mouth was limited, only able to open about 1 cm.

Doctors are examining patients.

Notably, the patient had a marked increase in muscle tone (muscle spasm) in the abdomen and throughout the body. Especially when there was a mechanical stimulus such as touching the person, the muscles in the body would react strongly, manifested through muscle spasms and stiffness. With the initial symptoms, the patient was diagnosed with: Generalized tetanus. Currently, the patient is sedated and ventilated via endotracheal tube.

MSc. Nguyen Thanh Bang, Emergency Department of the Central Hospital for Tropical Diseases, said that in the case of patient S., no external wounds or signs of trauma were found that could be a route of entry for tetanus spores.

Tetanus bacteria usually enter the body through open wounds on the skin, trauma, or surgery.

However, when the patient cannot clearly identify the wound entrance, the risk of tetanus infection can still come from small scratches during previous work and daily activities that the patient did not notice, because tetanus has a long incubation period, so the patient cannot remember exactly.

There are reports of tetanus occurring after dental infections, such as tooth decay, tooth extraction, periapical abscesses, etc.

In the case of patient S., we think a lot about the cause of tetanus from the oral cavity. In addition, in some rare cases, tetanus bacteria can enter through intestinal lesions or infections, such as from surgical wounds during endoscopy or small lesions in the stomach, rectum, or anus.

Therefore, early recognition of suspicious signs (progressive jaw stiffness, muscle stiffness) and taking appropriate preventive measures are key factors in protecting health and preventing serious developments of the disease.

Doctor Bang recommends that farmers and manual laborers who are in frequent contact with the ground should get regular tetanus shots and take protective measures while working to limit injuries.

In addition, any wound on the body, no matter how small, needs to be treated properly, with deep and dirty wounds need to be treated at medical facilities, and open wounds should not be exposed to mud. In addition, it is also necessary to ensure general oral hygiene.

If symptoms such as difficulty opening the mouth, difficulty speaking, or difficulty eating appear, the patient should go immediately to a medical facility for examination and early detection of the disease.