scholarly journals Cephalic Tetanus without Injury – A Rare Presentation of Tetanus

2021 ◽  
Vol 10 (20) ◽  
pp. 1555-1557
Author(s):  
Ramanan B.B.V ◽  
Ajit Kumar Pegu ◽  
Anupam Dutta ◽  
Arjit Das ◽  
Sanchu T.K. Sreeraj
Keyword(s):  
Case Report ◽  
Clostridium Tetani ◽  
Rare Presentation ◽  
Puncture Wound ◽  
Rare Manifestation ◽  
Life Threatening ◽  
Cephalic Tetanus

Tetanus is a rare, severe, and potentially life-threatening disease caused by Clostridium tetani, which accounted 58,900 deaths worldwide in 2013.1 Usually tetanus is generalized, rarely it can be localized also. 20-30% of cases will not have any puncture wound. In this case report, we present a case of tetanus with rare manifestation (localized tetanus presented with trismus without any puncture wound). Multiple rare associations like tetanus presenting with trismus, tetanus occurring in the absence of puncture wound strengthens the need for reporting this case which if left unnoticed would have been detrimental to the patient.

scholarly journals Botulinum toxin A for trismus in cephalic tetanus

1994 ◽  
Vol 52 (3) ◽  
pp. 410-413 ◽  
Author(s):  
Luiz Augusto F. Andrade ◽  
Sonia Maria D. Brucki
Keyword(s):  
Botulinum Toxin ◽  
Botulinum Toxin A ◽  
Pulmonary Complications ◽  
Toxin A ◽  
Clostridium Tetani ◽  
Considerable Difficulty ◽  
Respiratory Problems ◽  
Life Threatening ◽  
The Difference ◽  
Cephalic Tetanus

Cephalic tetanus is a localized form of tetanus. As in generalized forms , trismus is a prominent feature of the disease, leading to considerable difficulty in feeding, swallowing of the saliva and mouth hygiene. These difficulties often precede respiratory problems and aspiration bronchopneumonia is a frequent life-threatening complication. Muscle relaxants other than curare drugs may show a limited benefit for relieving trismus. Tetanospasmin, the tetanic neurotoxin, and botulinum toxin share many similarities, having a closely related chemical structure, an origin from related microorganisms (Clostridium tetani and Clostridium botulinum, respectively), and presumably, the same mechanisms of action in the neuron. The difference between the two lies in their peculiar neurospecificity, acting in different neurons. Injection of minute doses of botulinum toxin in the muscles involved in focal dystonias or other localized spastic disorders have proved to be very effective in these conditions. We describe the use of botulinum toxin A in the successful treatment of trismus in a patient suffering from cephalic tetanus. We believe that this form of treatment may be of value in lowering the risk of pulmonary complications in tetanic patients.

Ketamine in the management of generalised cephalic tetanus

2007 ◽  
Vol 122 (12) ◽  
pp. 1389-1391 ◽  
Author(s):  
O Obanor ◽  
H O Osazuwa ◽  
J E O Amadasun
Keyword(s):  
Case Report ◽  
Mortality Rate ◽  
Airway Obstruction ◽  
High Mortality ◽  
Adjunctive Therapy ◽  
Anaesthetic Agent ◽  
Purulent Discharge ◽  
Clostridium Tetani ◽  
History Of ◽  
Cephalic Tetanus

AbstractBackground:Tetanus is a fatal infection caused by the neurotoxin tetanospasmin released by the vegetative spores of Clostridium tetani. The high mortality rate is related to frequent tetanic fits with laryngeal spasm and airway obstruction. Numerous anticonvulsants are in use, with varying efficacy in controlling fits. This case report highlights the use of ketamine as adjunctive therapy in the management of tetanus.Case report:A 20-year-old woman was admitted with a history of recurrent left ear pain, with bloody, purulent discharge, following a self-inflicted injury. She developed tetanic spasms 24 hours after admission. She had received no immunisations. A tracheostomy was established to relieve airway obstruction, and ketamine was added to the medication when breakthrough seizures were refractory to diazepam.Conclusion:Ketamine is of proven safety as an anaesthetic agent, especially in cases in which an anaesthetist is not readily available. Its effectiveness in this case, in combination with diazepam, warrants further evaluation.

scholarly journals Autonomic instability in severe tetanus: a case report

2021 ◽  
Vol 23 (2) ◽  
pp. 117-120
Author(s):  
Seung Won Seo ◽  
Jaewon Lee ◽  
Bong-Goo Yoo ◽  
Jehun Kim ◽  
So-Young Huh
Keyword(s):  
Infectious Disease ◽  
Nervous System ◽  
Case Report ◽  
Autonomic Dysfunction ◽  
Ankle Fracture ◽  
Clostridium Tetani ◽  
Cardiovascular Instability ◽  
Autonomic Instability ◽  
Life Threatening ◽  
Severe Tetanus

Tetanus is an infectious disease of the nervous system caused by Clostridium tetani, and is characterized by tonic muscle contractions, painful spasms, and autonomic dysfunction. Severe autonomic dysfunction associated with tetanus can be life-threatening. We present a 62-year-old female who experienced lockjaw after an ankle fracture. The patient was diagnosed with tetanus and received tetanus immunoglobulin and a vaccination. The patient subsequently experienced labile hypertension. This case highlights the challenge and importance of managing cardiovascular instability.

Life-threatening hypercalcemia and primary plasma cell leukemia: a case report of a rare presentation

2018 ◽  
pp. 42-44
Author(s):  
Abdelaziz Khalloufi ◽  
Ilyas Kassimi ◽  
Abdelghafour Elkoundi ◽  
Zineb Taki ◽  
Mohamed Hassani ◽  
...  
Keyword(s):  
Case Report ◽  
Plasma Cell ◽  
Plasma Cell Leukemia ◽  
Cell Leukemia ◽  
Rare Presentation ◽  
Life Threatening ◽  
Primary Plasma Cell Leukemia

A Case of Cephalic Tetanus in a Developed Country

2013 ◽  
Vol 26 (1) ◽  
pp. 273-277 ◽  
Author(s):  
S. Fusetti ◽  
C. Ghirotto ◽  
G. Ferronato
Keyword(s):  
Masticatory Muscles ◽  
Skin Wound ◽  
Clostridium Tetani ◽  
Developed Country ◽  
Facial Region ◽  
Presenting Symptoms ◽  
Spasmodic Contraction ◽  
Important Health ◽  
Life Threatening ◽  
Cephalic Tetanus

Tetanus is a potentially life-threatening infection that results from contamination of skin wound by Clostridium Tetani spores. Although, it remains an important health problem in developing countries without strict national immunization programs, this condition is rare in the developed world. The most frequent presenting symptoms are trismus and dysphagia, due to the spasmodic contraction of the masticatory muscles. Then the disease usually diffuses with a descending pattern inducing a generalized contraction of the agonist and antagonistic muscles, which characterize a tetanic spasm. Mortality usually results from respiratory failure, cardiovascular collapse, or autonomic dysfunctions. Treatment usually requires the prompt admission to the intensive care unit to avoid the development of potential life-threatening complications. We report the case of a 78-year-old farmer, who was referred to us with progressive onset of lock-jaw and muscular stiffness of the facial region, that had occurred after he had scratched himself with a rose. The recognition of the presenting signs of cephalic tetanus allowed the prompt management of the infection. However, because of the rarity of this condition, the clinicians may be unfamiliar with the clinical presentation, and be unsuspecting of the diagnosis.

scholarly journals Case Report: Alpelisib-Induced Drug Reaction With Eosinophilia and Systemic Symptoms: A Rare Manifestation of a Common Side Effect

2021 ◽  
Vol 11 ◽  
Author(s):  
Umair Majeed ◽  
Tudor Puiu ◽  
Jason Sluzevich ◽  
Gina Reynolds ◽  
Marites Acampora ◽  
...  
Keyword(s):  
Drug Reaction ◽  
Case Report ◽  
Side Effect ◽  
Common Side Effect ◽  
Dress Syndrome ◽  
Initial Exposure ◽  
First Case ◽  
Rare Manifestation ◽  
Life Threatening ◽  
Systemic Symptoms

Alpelisib is a PIK3a inhibitor approved for the treatment of metastatic ER+ breast cancer in combination with fulvestrant. Although rash is a common side effect of this medication, we present the first case of drug reaction with eosinophilia and systemic symptoms (DRESS) upon initial exposure to alpelisib. Here we describe the clinical-pathological findings and management of our patient with alpelisib-induced life-threatening DRESS syndrome. The goal of this case report is to highlight association of alpelisib with DRESS syndrome, in clinical practice, so that alpelisib can be immediately stopped and treatment for this serious condition promptly initiated.

Presentation of Gall Stone Ileus as Gut Obstruction

JMS SKIMS ◽  
2019 ◽  
Vol 21 (2) ◽  
pp. 117-119
Author(s):  
Munir Ahmad Wani ◽  
Mubarak Ahmad Shan ◽  
Syed Muzamil Andrabi ◽  
Ajaz Ahmad Malik
Keyword(s):  
Abdominal Pain ◽  
Case Report ◽  
Ct Scan ◽  
Bowel Obstruction ◽  
Emergency Surgery ◽  
Gallstone Ileus ◽  
Gall Stone ◽  
Life Threatening ◽  
Life Threatening Complication ◽  
Gall Stone Ileus

Gallstone ileus is an uncommon and often life-threatening complication of cholelithiasis. In this case report, we discuss a difficult diagnostic case of gallstone ileus presenting as small gut obstruction with ischemia. A 56-year-old female presented with abdominal pain and vomiting. A CT scan was performed and showed an evolving bowel obstruction with features of gut ischemia with pneumobilia although no frank hyper density suggestive of a gallstone was noted. The patient underwent emergency surgery and a 60 mm obstructing calculus was removed from the patient's jejunum, with a formal tube cholecystostomy. JMS 2018: 21 (2):117-119

scholarly journals When systemic lupus erythematosus affects vision: a rare presentation of this condition

2020 ◽  
Vol 13 (1) ◽  
pp. e229382
Author(s):  
Tiago Gama Ramires ◽  
Luísa Vieira ◽  
Nuno Riso ◽  
Maria Francisca Moraes-Fontes
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Systemic Lupus ◽  
Blurred Vision ◽  
Rare Presentation ◽  
Complement Components ◽  
Oral Ulcers ◽  
Dsdna Antibody ◽  
Rare Manifestation ◽  
Retinal Vascular Tortuosity

A 23-year-old woman with fever, oral ulcers, arthalgias and weight loss of 2-week duration suddenly developed blurred vision, with reduced visual acuity, cotton wool exudates and retinal vascular tortuosity. Laboratory testing revealed anaemia, lymphopaenia, positive antinuclear antibody and high anti-dsDNA antibody titre with low complement components. There was no evidence of infection, clinching the diagnosis of lupus retinopathy. Steroid therapy alone was highly effective and was also accompanied by a normalisation of haemoglobin and lymphocyte counts, after which azathioprine was added. Hydroxychloroquine was introduced after resolution of retinal changes. Immunosuppressive therapy was progressively tapered over the course of 12 months and then discontinued, and the patient remains in remission 48 months after the initial presentation. Our patient exemplifies a very rare manifestation of systemic lupus erythematosus. We emphasise the importance of its early detection and complexity of treatment in order to reduce visual morbidity.

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