CP3 - Generalized tetanus following a deep foot njury: A Case report

Abstract

Introduction

Tetanus is a life-threatening but vaccine-preventable disease caused by the neurotoxin of Clostridium tetani. Despite global eradication efforts, sporadic cases still occur, particularly in areas with incomplete immunization coverage.

Case Report

We report a case of generalized tetanus in a previously healthy 48-year-old male who sustained a deep puncture wound to his right foot while working in a field contaminated with goat excreta. He received wound care and a dose of tetanus toxoid at a peripheral hospital, and there was no documentation of prior tetanus immunization.

Three days post-injury, he developed trismus, generalized muscle rigidity, risus sardonicus, and painful spasms. On admission, he was treated with intravenous metronidazole and tetanus immune globulin (TIG) and received intensive care, including sedation, muscle relaxants, and magnesium sulfate for autonomic instability. Wound debridement was also performed. Despite the severity of symptoms, mechanical ventilation was not required. The patient gradually improved and underwent physiotherapy, completing a full course of tetanus vaccination prior to discharge.

Discussion

This case underscores the importance of thorough wound assessment and proper post-exposure prophylaxis, particularly in adults with unknown vaccination status.

Conclusion:

Prevention through vaccination, timely prophylaxis, appropriate wound management, and increased awareness among healthcare providers are critical to reducing the morbidity and mortality associated with tetanus.