Successful management of severe generalized tetanus in a 23‐year man with phenobarbital adjuvant: A case report
Key Clinical Message Generalized tetanus is still a global concern with a mortality rate of up to 50%, especially in low and middle‐income countries. We reported a 23‐year‐old man from Afghanistan admitted to emergency department, with the chief complaint of generalized severe spasms and lockjaw. Th...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2023-12-01
|
| Series: | Clinical Case Reports |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/ccr3.8286 |
| _version_ | 1797372054507356160 |
|---|---|
| author | Arezoo Ahmadi Elahe Karimpour‐Razkenari Ramin Ansari Mahforouzalsadat Marashi Hamidreza Sharifnia Atabak Najafi Mojtaba Mojtahedzadeh |
| author_facet | Arezoo Ahmadi Elahe Karimpour‐Razkenari Ramin Ansari Mahforouzalsadat Marashi Hamidreza Sharifnia Atabak Najafi Mojtaba Mojtahedzadeh |
| author_sort | Arezoo Ahmadi |
| collection | DOAJ |
| description | Key Clinical Message Generalized tetanus is still a global concern with a mortality rate of up to 50%, especially in low and middle‐income countries. We reported a 23‐year‐old man from Afghanistan admitted to emergency department, with the chief complaint of generalized severe spasms and lockjaw. The patient had skin lesions and had never been vaccinated against tetanus. He intubated and admitted to the intensive care unit (ICU) with diagnose of severe generalized tetanus. After receiving tetanus immunoglobulin and intravenous metronidazole, a combination therapy of midazolam, propofol, atracurium, and morphine was administered. Due to the refractory muscular spasms intravenous phenobarbital started and little by little recovery was achieved. The patient receiving the first two doses of the Td vaccine, and discharged on Day 42 of hospitalization with no symptom recurrence. This case management showed adding phenobarbital to severe tetanus treatment regimen could significantly reduce refractory spasm caused by tetanus, also decrease other medication requirement. |
| first_indexed | 2024-03-08T18:30:53Z |
| format | Article |
| id | doaj.art-920f8a25a0fb4a78900b763cf0217f9e |
| institution | Directory Open Access Journal |
| issn | 2050-0904 |
| language | English |
| last_indexed | 2024-03-08T18:30:53Z |
| publishDate | 2023-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | Clinical Case Reports |
| spelling | doaj.art-920f8a25a0fb4a78900b763cf0217f9e2023-12-30T04:35:09ZengWileyClinical Case Reports2050-09042023-12-011112n/an/a10.1002/ccr3.8286Successful management of severe generalized tetanus in a 23‐year man with phenobarbital adjuvant: A case reportArezoo Ahmadi0Elahe Karimpour‐Razkenari1Ramin Ansari2Mahforouzalsadat Marashi3Hamidreza Sharifnia4Atabak Najafi5Mojtaba Mojtahedzadeh6Department of Anesthesiology and Critical Care, School of Medicine, Sina Hospital Tehran University of Medical Sciences Tehran IranDepartment of Clinical Pharmacy, Faculty of Pharmacy Tehran University of Medical Sciences Tehran IranDepartment of Clinical Pharmacy, Faculty of Pharmacy Tehran University of Medical Sciences Tehran IranDepartment of Infectious Disease and Tropical Medicine, School of Medicine, Sina Hospital Tehran University of Medical Sciences Tehran IranDepartment of Anesthesiology and Critical Care, School of Medicine, Sina Hospital Tehran University of Medical Sciences Tehran IranDepartment of Anesthesiology and Critical Care, School of Medicine, Sina Hospital Tehran University of Medical Sciences Tehran IranDepartment of Clinical Pharmacy, Faculty of Pharmacy Tehran University of Medical Sciences Tehran IranKey Clinical Message Generalized tetanus is still a global concern with a mortality rate of up to 50%, especially in low and middle‐income countries. We reported a 23‐year‐old man from Afghanistan admitted to emergency department, with the chief complaint of generalized severe spasms and lockjaw. The patient had skin lesions and had never been vaccinated against tetanus. He intubated and admitted to the intensive care unit (ICU) with diagnose of severe generalized tetanus. After receiving tetanus immunoglobulin and intravenous metronidazole, a combination therapy of midazolam, propofol, atracurium, and morphine was administered. Due to the refractory muscular spasms intravenous phenobarbital started and little by little recovery was achieved. The patient receiving the first two doses of the Td vaccine, and discharged on Day 42 of hospitalization with no symptom recurrence. This case management showed adding phenobarbital to severe tetanus treatment regimen could significantly reduce refractory spasm caused by tetanus, also decrease other medication requirement.https://doi.org/10.1002/ccr3.8286intensive care unitphenobarbitalrefractory spasmtetanus |
| spellingShingle | Arezoo Ahmadi Elahe Karimpour‐Razkenari Ramin Ansari Mahforouzalsadat Marashi Hamidreza Sharifnia Atabak Najafi Mojtaba Mojtahedzadeh Successful management of severe generalized tetanus in a 23‐year man with phenobarbital adjuvant: A case report Clinical Case Reports intensive care unit phenobarbital refractory spasm tetanus |
| title | Successful management of severe generalized tetanus in a 23‐year man with phenobarbital adjuvant: A case report |
| title_full | Successful management of severe generalized tetanus in a 23‐year man with phenobarbital adjuvant: A case report |
| title_fullStr | Successful management of severe generalized tetanus in a 23‐year man with phenobarbital adjuvant: A case report |
| title_full_unstemmed | Successful management of severe generalized tetanus in a 23‐year man with phenobarbital adjuvant: A case report |
| title_short | Successful management of severe generalized tetanus in a 23‐year man with phenobarbital adjuvant: A case report |
| title_sort | successful management of severe generalized tetanus in a 23 year man with phenobarbital adjuvant a case report |
| topic | intensive care unit phenobarbital refractory spasm tetanus |
| url | https://doi.org/10.1002/ccr3.8286 |
| work_keys_str_mv | AT arezooahmadi successfulmanagementofseveregeneralizedtetanusina23yearmanwithphenobarbitaladjuvantacasereport AT elahekarimpourrazkenari successfulmanagementofseveregeneralizedtetanusina23yearmanwithphenobarbitaladjuvantacasereport AT raminansari successfulmanagementofseveregeneralizedtetanusina23yearmanwithphenobarbitaladjuvantacasereport AT mahforouzalsadatmarashi successfulmanagementofseveregeneralizedtetanusina23yearmanwithphenobarbitaladjuvantacasereport AT hamidrezasharifnia successfulmanagementofseveregeneralizedtetanusina23yearmanwithphenobarbitaladjuvantacasereport AT atabaknajafi successfulmanagementofseveregeneralizedtetanusina23yearmanwithphenobarbitaladjuvantacasereport AT mojtabamojtahedzadeh successfulmanagementofseveregeneralizedtetanusina23yearmanwithphenobarbitaladjuvantacasereport |