Doctors puzzled over the cause of tetanus in 65-year-old man

On November 6, the Tropical Diseases Hospital reported a severe case of tetanus but the cause of the disease was not clearly identified. The patient was LVS, (65 years old, from Hai Duong ), who had a history of good health, without any signs of wounds or scratches on his body. However, 10 days before being admitted to the hospital, Mr. S had a sore throat but no fever and was diagnosed with acute pharyngitis and prescribed medication for outpatient treatment.

Mr. LVS was hospitalized for emergency treatment due to tetanus, but the cause is unknown. (Photo: MT).

After 6 days of using the medicine, Mr. S showed unusual symptoms such as difficulty opening his mouth, difficulty speaking and poor appetite, so his family took him to the doctor. At the medical facility, he was diagnosed with tetanus and transferred to the Central Hospital for Tropical Diseases.

At the Emergency Department of the Central Hospital for Tropical Diseases, the patient's initial condition was quite alert, no fever, no convulsions, but the ability to open the mouth was limited, only about 1 cm. Notably, the patient had obvious muscle spasms in the abdomen and the whole body, so he was diagnosed with generalized tetanus. Currently, the patient is sedated and on a ventilator via endotracheal intubation.

MSc. Dr. Nguyen Thanh Bang, Department of Emergency Medicine, Central Hospital for Tropical Diseases, said: “In the case of patient S, there were no skin wounds or signs of trauma that could be the route of entry for tetanus spores. Normally, tetanus bacteria enter the body through open wounds on the skin, trauma, or surgery. However, when the patient cannot clearly identify the route of entry, the risk of tetanus infection can still come from small scratches during previous work and daily activities that the patient did not notice, because tetanus has a long incubation period.”

Dr. Bang added that there are reports showing that tetanus appears after oral infections, such as tooth decay, tooth extraction, peri-dental abscess, etc. With patient S, we think more about the cause of tetanus from the oral cavity. In addition, in some rare cases, tetanus bacteria can enter through intestinal lesions or infections, such as from surgical wounds during endoscopy or small injuries in the stomach, rectum, or anus.

“With tetanus, early recognition of suspicious signs (progressive jaw stiffness, muscle stiffness) and taking appropriate precautions are key factors in protecting health and preventing serious developments of the disease,” Dr. Bang informed.

Infectious disease doctors also recommend: “For those who work in agriculture, manual labor, and are in frequent contact with the ground; they need to get regular tetanus shots and take protective measures when working to limit injuries. Any wound on the body, no matter how small, needs to be treated properly. Deep, dirty wounds need to be treated at medical facilities and open wounds should not be exposed to mud. In addition, it is necessary to ensure general oral hygiene. If signs such as difficulty opening the mouth, difficulty speaking, or difficulty eating appear, the patient should go to a medical facility immediately for examination and early detection of the disease…”.

Source: https://www.baogiaothong.vn/bac-si-boi-roi-tim-nguyen-nhan-gay-uon-van-cho-nguoi-dan-ong-65-tuoi-192241106145044741.htm