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Unprotected People Reports: Tetanus |
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Death from Tetanus after a Pretibial Laceration |
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| Click here for a fully-formatted PDF version
of this report |
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| The Immunization Action Coalition (IAC)
publishes articles about people who have suffered or died from
vaccine-preventable diseases and periodically devotes an “IAC Express”
issue to such an article. This is the 60th in our series. |
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| It was published in the “British Medical
Journal” June 15, 2002. The introduction and case report are reprinted
below. |
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By Oliver C S Casssell, consultant
Department of Plastic and Reconstructive Surgery, Radcliffe Infirmary,
Oxford |
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Clinicians should be familiar with
Department of Health guidelines for immunoprophylaxis when wounds through
which tetanus can be acquired occur. I report on a patient in whom tetanus
immunoprophylaxis did not follow the guidelines.
Case report
A 76 year old woman fell in her garden and
sustained a pretibial laceration. Her wound was cleaned and approximated
with Steri-strips (3M; Loughborough) at an emergency department. Her
status for tetanus immunisation at the time was recorded as "no previous
tetanus injection," and a course of antitetanus treatment was started.
However, no immunoglobulin was given.
She returned one week later with a necrotic
and malodorous wound. She was unwell and complained of diffuse pains. She
was admitted for debridement and split skin grafting.
Her condition worsened. Twenty four hours
later she developed the signs and symptoms of tetanus, with increasing jaw
stiffness, opisthotonos, and generalised limb spasticity. Cultures from
the wound produced a heavy growth of Clostridium tetanii. She was
transferred to intensive care but died 22 days later.
To access the complete article, go to: http://bmj.bmjjournals.com/cgi/content/full/324/7351/1442
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| 10/31/03 • REPORT #60 |
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| Disclaimer: The Immunization Action Coalition (IAC) publishes
Unprotected People Reports for the purpose of making them available
for our readers' review. We have not verified the content of this
report. |
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