2018, Number 2
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Revista Cubana de Anestesiología y Reanimación 2018; 17 (2)
Generalized tetanus as a complication of closed fracture of the tibia and the fibula
Casacó VI
Language: Spanish
References: 19
Page: 1-7
PDF size: 260.20 Kb.
ABSTRACT
Introduction: Tetanus is a preventable infectious disease that can cause death. The
clinical manifestations are due to a powerful toxin secreted by Clostridiumtetani, a
Gram-positive bacillus that penetrates through losses of skin continuity, regardless of
the wound's size.
Objective: To present the clinical evolution of a female patient living in a rural area
in Latacunga, Cotopaxi, Ecuador.
Development: Patient with no history of previous immunization who went to the
emergency room due to a closed fracture of the tibia and the fibula in the left lower
limb as a result of a traffic accident. The clinical diagnosis of generalized tetanus was
based on the appearance on the ninth day of dysphagia´s trauma, trismus, nuchal
rigidity, and later on: generalized contractures with opistho-tonus, cardiorespiratory
arrest, and autonomic dysfunction. With a prolonged hospital stay of 82 days, she
received anesthesia under critical conditions in 15 occasions, and suffered serious
complications. She remained for 46 days in the intensive care unit.
Conclusions: This case emphasizes the permanent threat of tetanus in this
environment, as well as the need to implement immunization schemes in a more
comprehensive and constant manner.
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