Tetanus

A clinical review

Juma M. Al-Kaabi, Euan M. Scrimgeour, Andre Louon, Bazdawi M. Al-Riyami

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Objectives: Although tetanus is now uncommon in Oman (The Expanded Program on Immunization was introduced in 1981), patients continue to present from time to time at an average rate of 6 cases per year. Worldwide, the mortality rate for tetanus remains high (ranging from 15-20% in developed countries). At the Sultan Qaboos University Hospital, Muscat, Oman, prolonged Intensive Care Unit treatment and multi-disciplinary management is invariably required for tetanus patients. This study was carried out to evaluate our results over the past decade. Methods: All tetanus patients admitted to the Sultan Qaboos University Hospital from 1991 up to the end of 1999 were retrospectively reviewed. Patients were diagnosed early, and aggressive treatment in the Intensive Care Unit was instituted, with a coordinated multidisciplinary management. Results: Ten cases were identified and included in the review, comprising 9 adults and one infant aged 2 weeks. Adult patients were aged 36-75 years (mean 59 years), and the average Intensive Care Unit stay of the 9 surviving patients was 5.5 weeks (range 3-7 weeks). All patients presented with severe generalized tetanus. Two patients with traditional cautery marks developed tetanus. A focus of infection could not be found in 2 patients. All patients had early tracheostomy and assisted ventilation with appropriate sedation. One patient required almost 45 gm of diazepam throughout his Intensive Care Unit stay. One adult patient died on the 6th day of admission following myocardial infarction. The neonatal case survived after 35 days care in the Intensive Care Unit. The mortality rate for our patients was therefore 10%. Conclusion: Tetanus in Oman remains an infrequent but important disease requiring costly and prolonged Intensive Care Unit treatment. We attribute the comparatively low mortality rate (10%) in this study, to early diagnosis, institution of aggressive treatment, good nursing as well as a well-coordinated multi-disciplinary management.

Original languageEnglish
Pages (from-to)606-609
Number of pages4
JournalSaudi Medical Journal
Volume22
Issue number7
Publication statusPublished - Jul 2001

Fingerprint

Tetanus
Intensive Care Units
Oman
Mortality
Cautery
Immunization Programs
Tracheostomy
Therapeutics
Diazepam
Developed Countries
Ventilation
Early Diagnosis
Nursing
Myocardial Infarction

Keywords

  • Cautery burns
  • Immunization
  • Risus Sardonicus
  • Tetanus
  • Tetanus management

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Al-Kaabi, J. M., Scrimgeour, E. M., Louon, A., & Al-Riyami, B. M. (2001). Tetanus: A clinical review. Saudi Medical Journal, 22(7), 606-609.

Tetanus : A clinical review. / Al-Kaabi, Juma M.; Scrimgeour, Euan M.; Louon, Andre; Al-Riyami, Bazdawi M.

In: Saudi Medical Journal, Vol. 22, No. 7, 07.2001, p. 606-609.

Research output: Contribution to journalArticle

Al-Kaabi, JM, Scrimgeour, EM, Louon, A & Al-Riyami, BM 2001, 'Tetanus: A clinical review', Saudi Medical Journal, vol. 22, no. 7, pp. 606-609.
Al-Kaabi JM, Scrimgeour EM, Louon A, Al-Riyami BM. Tetanus: A clinical review. Saudi Medical Journal. 2001 Jul;22(7):606-609.
Al-Kaabi, Juma M. ; Scrimgeour, Euan M. ; Louon, Andre ; Al-Riyami, Bazdawi M. / Tetanus : A clinical review. In: Saudi Medical Journal. 2001 ; Vol. 22, No. 7. pp. 606-609.
@article{3e408bfd9d014777a232982c0c6f65dd,
title = "Tetanus: A clinical review",
abstract = "Objectives: Although tetanus is now uncommon in Oman (The Expanded Program on Immunization was introduced in 1981), patients continue to present from time to time at an average rate of 6 cases per year. Worldwide, the mortality rate for tetanus remains high (ranging from 15-20{\%} in developed countries). At the Sultan Qaboos University Hospital, Muscat, Oman, prolonged Intensive Care Unit treatment and multi-disciplinary management is invariably required for tetanus patients. This study was carried out to evaluate our results over the past decade. Methods: All tetanus patients admitted to the Sultan Qaboos University Hospital from 1991 up to the end of 1999 were retrospectively reviewed. Patients were diagnosed early, and aggressive treatment in the Intensive Care Unit was instituted, with a coordinated multidisciplinary management. Results: Ten cases were identified and included in the review, comprising 9 adults and one infant aged 2 weeks. Adult patients were aged 36-75 years (mean 59 years), and the average Intensive Care Unit stay of the 9 surviving patients was 5.5 weeks (range 3-7 weeks). All patients presented with severe generalized tetanus. Two patients with traditional cautery marks developed tetanus. A focus of infection could not be found in 2 patients. All patients had early tracheostomy and assisted ventilation with appropriate sedation. One patient required almost 45 gm of diazepam throughout his Intensive Care Unit stay. One adult patient died on the 6th day of admission following myocardial infarction. The neonatal case survived after 35 days care in the Intensive Care Unit. The mortality rate for our patients was therefore 10{\%}. Conclusion: Tetanus in Oman remains an infrequent but important disease requiring costly and prolonged Intensive Care Unit treatment. We attribute the comparatively low mortality rate (10{\%}) in this study, to early diagnosis, institution of aggressive treatment, good nursing as well as a well-coordinated multi-disciplinary management.",
keywords = "Cautery burns, Immunization, Risus Sardonicus, Tetanus, Tetanus management",
author = "Al-Kaabi, {Juma M.} and Scrimgeour, {Euan M.} and Andre Louon and Al-Riyami, {Bazdawi M.}",
year = "2001",
month = "7",
language = "English",
volume = "22",
pages = "606--609",
journal = "Saudi Medical Journal",
issn = "0379-5284",
publisher = "Saudi Arabian Armed Forces Hospital",
number = "7",

}

TY - JOUR

T1 - Tetanus

T2 - A clinical review

AU - Al-Kaabi, Juma M.

AU - Scrimgeour, Euan M.

AU - Louon, Andre

AU - Al-Riyami, Bazdawi M.

PY - 2001/7

Y1 - 2001/7

N2 - Objectives: Although tetanus is now uncommon in Oman (The Expanded Program on Immunization was introduced in 1981), patients continue to present from time to time at an average rate of 6 cases per year. Worldwide, the mortality rate for tetanus remains high (ranging from 15-20% in developed countries). At the Sultan Qaboos University Hospital, Muscat, Oman, prolonged Intensive Care Unit treatment and multi-disciplinary management is invariably required for tetanus patients. This study was carried out to evaluate our results over the past decade. Methods: All tetanus patients admitted to the Sultan Qaboos University Hospital from 1991 up to the end of 1999 were retrospectively reviewed. Patients were diagnosed early, and aggressive treatment in the Intensive Care Unit was instituted, with a coordinated multidisciplinary management. Results: Ten cases were identified and included in the review, comprising 9 adults and one infant aged 2 weeks. Adult patients were aged 36-75 years (mean 59 years), and the average Intensive Care Unit stay of the 9 surviving patients was 5.5 weeks (range 3-7 weeks). All patients presented with severe generalized tetanus. Two patients with traditional cautery marks developed tetanus. A focus of infection could not be found in 2 patients. All patients had early tracheostomy and assisted ventilation with appropriate sedation. One patient required almost 45 gm of diazepam throughout his Intensive Care Unit stay. One adult patient died on the 6th day of admission following myocardial infarction. The neonatal case survived after 35 days care in the Intensive Care Unit. The mortality rate for our patients was therefore 10%. Conclusion: Tetanus in Oman remains an infrequent but important disease requiring costly and prolonged Intensive Care Unit treatment. We attribute the comparatively low mortality rate (10%) in this study, to early diagnosis, institution of aggressive treatment, good nursing as well as a well-coordinated multi-disciplinary management.

AB - Objectives: Although tetanus is now uncommon in Oman (The Expanded Program on Immunization was introduced in 1981), patients continue to present from time to time at an average rate of 6 cases per year. Worldwide, the mortality rate for tetanus remains high (ranging from 15-20% in developed countries). At the Sultan Qaboos University Hospital, Muscat, Oman, prolonged Intensive Care Unit treatment and multi-disciplinary management is invariably required for tetanus patients. This study was carried out to evaluate our results over the past decade. Methods: All tetanus patients admitted to the Sultan Qaboos University Hospital from 1991 up to the end of 1999 were retrospectively reviewed. Patients were diagnosed early, and aggressive treatment in the Intensive Care Unit was instituted, with a coordinated multidisciplinary management. Results: Ten cases were identified and included in the review, comprising 9 adults and one infant aged 2 weeks. Adult patients were aged 36-75 years (mean 59 years), and the average Intensive Care Unit stay of the 9 surviving patients was 5.5 weeks (range 3-7 weeks). All patients presented with severe generalized tetanus. Two patients with traditional cautery marks developed tetanus. A focus of infection could not be found in 2 patients. All patients had early tracheostomy and assisted ventilation with appropriate sedation. One patient required almost 45 gm of diazepam throughout his Intensive Care Unit stay. One adult patient died on the 6th day of admission following myocardial infarction. The neonatal case survived after 35 days care in the Intensive Care Unit. The mortality rate for our patients was therefore 10%. Conclusion: Tetanus in Oman remains an infrequent but important disease requiring costly and prolonged Intensive Care Unit treatment. We attribute the comparatively low mortality rate (10%) in this study, to early diagnosis, institution of aggressive treatment, good nursing as well as a well-coordinated multi-disciplinary management.

KW - Cautery burns

KW - Immunization

KW - Risus Sardonicus

KW - Tetanus

KW - Tetanus management

UR - http://www.scopus.com/inward/record.url?scp=0034893806&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0034893806&partnerID=8YFLogxK

M3 - Article

VL - 22

SP - 606

EP - 609

JO - Saudi Medical Journal

JF - Saudi Medical Journal

SN - 0379-5284

IS - 7

ER -