[Tetanus in intensive care units].
BACKGROUND
Tetanus is medical disease with a high mortality rate, even in high tech centres and in Intensive Care Units (ICU). AIMS. To analyse the appearance and evolution of tetanus in the ICU at our hospital.


METHODS
This retrospective descriptive study, made up of 26 patients admitted to hospital with tetanus in the ICU at the Hospital Escuela during the period between January 1995 and December 2001, examined the clinico epidemiological of the disease and the clinical evolution of the patients.


RESULTS
Of the cases reviewed (n= 26), 34.6% were females and 65.4% males. The main clinical manifestations were: trismus (88%), dysphagia (77%) and cervical rigidity (69%). The incubation period varies from 3 days to 4 weeks. Most cases resulted from cut wounds (54%), to a lesser extent from excoriations (15%), and one case was associated with gynaecological surgery. The entry sites of the injuries were mainly on the upper (42%) and lower limbs (34.6%). Three patients had been vaccinated and 17 had not. Six cases were not recorded. The chief complications that developed were: dysautonomia (73%) and pneumonia (42%). The mortality rate was 69%.


CONCLUSIONS
In spite of having suitable equipment available with which to treat tetanus, mortality is high, mainly because of dysautonomias. Prevention is therefore the most effective way of controlling this disease
Orellana-San Martín
C
C
Hospital Escuela, Honduras, Honduras.
Su
H
H
Bustamante-Durán
D
D
Velásquez-Pagoaga
L
L
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007114:Immunization; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D012189:Retrospective Studies; D013742:Tetanus / Q000150:complications / Q000453:epidemiology* / Q000401:mortality / Q000503:physiopathology