[Localized tetanus in Abidjan: clinical and prognostic features (1976-1997)].
Localised tetanus, rarely described in Africa, was examined retrospectively in Abidjan, over a period of 22 years (1976-97). Forty-five patients--representing an incidence rate of 2% of tetanus cases--were reported in this time span. The mean age was 23 years, and none of the patients had had prior access to adequate immunoprophylaxis. Three clinical forms were observed: tetanus of the limbs (32 cases, 71%), cephalic tetanus (11 cases, 25%), and abdominal tetanus (2 cases, 4%). Infection had occurred via wounds of the limbs (38%), intramuscular injections (33%), craniofacial wounds (25%), and abdominal wounds (2%). No portal of entry was identified for 2% of the cases. 37 patients were cured (82%) of whom 5 retained sequelae (11%). 7 deaths were observed (16%). In terms of prognosis, the only risk was secondary generalisation of tetanus (27%).


CONCLUSIONS
Localised tetanus is far from being mild and incurs significant rates of sequelae. The only efficient treatment is immunisation-based prophylaxis.
Kakou
A R
AR
Clinique des maladies infectieuses, CHU de Treichville, 01 B.P. 8428, Abidjan 01, Côte d'Ivoire.
Eholie
S
S
Ehui
E
E
Ble
O
O
Bissagnene
E
E
Aoussi
E
E
Odehouri
K
K
Kadio
A
A
D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D007560:Cote d'Ivoire / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D013742:Tetanus / Q000453:epidemiology / Q000628:therapy / Q000635:transmission; D013745:Tetanus Toxoid
D000900:Anti-Bacterial Agents; D013745:Tetanus Toxoid