title: Tetanus in Finland: diagnostic problems and complications.
abstract: In a 16-year nationwide study in Finland 106 patients were diagnosed as having tetanus. Tetanus was diagnosed on the first visit to a doctor in half the patients, it was suspected in 28% but not considered in 22%. Diagnosis of tetanus may be delayed if a patient is elderly or has no known primary lesion. Abnormal EEGs and CSF findings with increased protein level were unexpectedly common (76% and 24% respectively). The most significant complications were cardiac arrhythmias (34%), blood pressure lability (32%), an increased haemorrhagic tendency (28%), an increase in thrombosis (8%) and/or of anoxic periods (16%) and death (11%). Intensive care has markedly improved the prognosis of tetanus; the main problems at present are difficulty of early diagnosis and treatment of complications of the most serious cases.
authors.affiliation: Department of Neurology, Kivelä Hospital, Helsinki, Finland.
authors.forename: M
authors.initials: M
authors.lastname: Luisto
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D004569:Electroencephalography; D005260:Female; D005387:Finland; D006801:Humans; D008297:Male; D008875:Middle Aged; D013742:Tetanus / Q000134:cerebrospinal fluid / Q000150:complications / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy