Critical due to tetanus infection
Patient N.V.G (male, 49 years old), previously healthy, working as a carpenter in Bac Ninh, went to Bach Mai Hospital with initial symptoms of jaw stiffness, difficulty opening the mouth, difficulty breathing, and difficulty walking.
After examination, the doctors concluded that the patient was suspected of having tetanus infection and admitted him to the Tropical Diseases Center for treatment with an initial diagnosis of generalized tetanus - respiratory failure. On the first night of hospitalization, the patient had difficulty breathing and had to have an emergency tracheostomy, high doses of anticonvulsants, vaccines and tetanus serum to neutralize the toxin and a ventilator to support his breathing.
The patient's medical history revealed that 2 weeks before being admitted to the hospital, the patient had been cut by a wood planer through the first phalanx of the third finger of his left hand, but he did not go to the hospital but treated the wound himself and applied leaves at home. Due to subjectivity, the patient did not get a tetanus shot after the injury.
Upon admission to the hospital, the wound on the finger was black and necrotic, suspected of containing a foreign object. The patient was treated with debridement and wound cleaning. However, after 2 weeks of treatment, the disease gradually progressed and required intensive care treatment with mechanical ventilation, blood filtration, high-dose antibiotics to fight infection, vasopressors, micronutrient supplementation, nutritional infusion, and after many multidisciplinary consultations, the patient was still in critical condition: septic shock, respiratory failure, acute liver and kidney failure, acute rhabdomyolysis, anuria, high risk of death.
Another case is patient N.V.M (male, 56 years old), a farmer in Hai Duong, who was admitted to the Tropical Diseases Center with a stiff jaw, difficulty eating, difficulty swallowing, unable to open his mouth, increased muscle tone throughout the body, headache, and fatigue. A week before, the patient had a boil on his big toe but subjectively waded in dirty water during the recent storm, so bacteria entered his body through the wound. Up to now, the patient has never been vaccinated against tetanus.
After more than a week of active monitoring and treatment, the patient's condition has improved. Although he does not need a tracheostomy or mechanical ventilation, he still has a high risk of death due to the possibility of complications such as respiratory failure and secondary infections due to many underlying diseases.
Do not ignore skin wounds
Associate Professor, Dr. Do Duy Cuong - Director of the Center for Tropical Diseases, Bach Mai Hospital said that tetanus is a very dangerous infectious - toxic disease caused by bacteria from the environment entering the body through wounds, secreting toxins that cause systemic poisoning. Clinical manifestations are symptoms of muscle stiffness and convulsions. Although the disease can be prevented by vaccination, when infected, it progresses very seriously with many complications.
Clinical symptoms are that after about 1-2 weeks of injury, the patient will have early symptoms of jaw stiffness, difficulty chewing, difficulty swallowing, then muscle stiffness, increased muscle tone throughout the body, severe cases will have symptoms of convulsions, the whole body is bent, accompanied by difficulty breathing, respiratory failure, autonomic nervous system disorders. If not treated promptly with active resuscitation measures, it will quickly lead to death or many complications in the cardiovascular, respiratory, urinary, digestive, and skeletal systems.
Regarding tetanus prevention, vaccination is recommended, especially for high-risk groups. Pregnant women need to be vaccinated against tetanus at the right time during pregnancy. It is important to note that when injured or scratched, the wound should be immediately disinfected properly, avoid covering the wound, and go to a medical facility to receive tetanus antiserum and treat the wound by cutting and filtering necrotic tissue, crushing, and removing foreign objects...
