title: Severe tetanus--in spite of tetanus toxoid.
abstract: A 66-year-old man sustained an injury to his right foot while gardening. Despite receiving tetanus toxoid one hour later and adequate wound toilet, he developed severe tetanus complicated with autonomic dysfunction six days later. He died 20 days after admission. This case shows that tetanus toxoid alone may not be sufficient to prevent tetanus in wounded patients. Careful consideration must be given to the immune status of the patient and to the nature of the wound sustained. Incompletely immunised patients or patients with unknown immune status who sustain a tetanus prone wound should be protected with both tetanus toxoid and tetanus immunoglobulin.
authors.affiliation: Muar Hospital, Muar Johor.
authors.forename: N
authors.initials: N
authors.lastname: Nivedita
mesh_terms: D000368:Aged; D001342:Autonomic Nervous System Diseases / Q000209:etiology*; D002985:Clinical Protocols; D017809:Fatal Outcome; D006801:Humans; D007115:Immunization Schedule; D008297:Male; D008487:Medical History Taking; D012307:Risk Factors; D013742:Tetanus / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology* / Q000276:immunology; D013745:Tetanus Toxoid / Q000627:therapeutic use*; D017211:Treatment Failure; D014950:Wounds, Penetrating / Q000150:complications*
chemical_list: D013745:Tetanus Toxoid