Clinical Profile, Management and Outcome in Paediatric Patients with Tetanus: A Case Series

Tetanus is an acute infectious disease, caused by spores of the bacterium Clostridium tetani. The spores are found everywhere in the environment, particularly in soil, ash, intestinal tracts/faeces of animals and humans, on the surfaces of skin and rusty tools like nails, needles, barbed wires, etc. Being very resistant to heat and most antiseptics, the spores can survive for years. Anyone can get tetanus, but the disease is particularly common and serious in new born babies and pregnant women, who have not been sufficiently immunised with Tetanus Toxoid (TT) containing vaccines. The disease remains an important public health problem in many parts of the world, but especially in low income countries or districts, where immunisation coverage is low and unclean birth practices are common. There are no particular diagnostic tests for tetanus, the diagnosis is made clinically. Hence, early identification of cases of tetanus becomes important for early intervention. Herein, the authors reported four cases (1 male and 3 females) of tetanus, with varied clinical manifestations, management and outcome. The patients were diagnosed with severe generalised tetanus, otogenic tetanus, mild generalised tetanus and severe generalised tetanus respectively. The patients were treated with inj. diazepam, inj. tetanus toxoid, inj. methocarbamol. Two of them recovered completely and two could not be revived.