Bronchoaspiration as a possible cause in a case of tetanus. A reminder on the importance of adulthood immunizations.
Although preventable by immunization tetanus still takes a large death toll, mostly in developing countries, where adult population is often unprotected and opportune medical care unavailable. We present a case of tetanus in an elderly patient with bronchoaspiration pneumonia after a near-drowning incident, in which no objective entry site could be suspected with as much temporal relation as the bronchoaspiration incident. Bronchoaspiration of organic matter and feces provides both a source of the causative agent and an adequate polymicrobial environment for the development of the disease. It is under such conditions that we propose this unusual entry site as the cause of tetanus in our patient. Special emphasis is made on the importance of adulthood immunization programs and how incidents like this one should be taken into account in the overall care provided to the elderly population.
División de Epidemiología Hospitalaria, Instituto Nacional de la Nutrición Salvador Zubirán, México, D.F., México.
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L
Ostrosky-Zeichner
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P
Volkow
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Ponce de León
D000059:Accidents; D000368:Aged; D003017:Clostridium tetani; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D009102:Multiple Organ Failure / Q000209:etiology; D015701:Near Drowning / Q000150:complications*; D011015:Pneumonia, Aspiration / Q000150:complications*; D013742:Tetanus / Q000517:prevention & control / Q000635:transmission*; D014871:Water Microbiology; D014876:Water Pollution