Tetanus: a retrospective study of clinical presentations and outcomes in a medical teaching hospital.
BACKGROUND
Tetanus has been a serious infectious disease with high mortality and morbidity. Some clinical factors can predict its severity.


OBJECTIVE
Survey the clinical profiles, their correlation with the severity of tetanus and the final outcomes after treatment.


METHODS
A retrospective study of the medical records of patients with tetanus who attended Songklanagarind hospital between January 1982 and June 2008 was done. The correlation between clinical profiles and severity was analyzed by Fisher exact test to detect the significant correlation (p < 0.05).


RESULTS
Forty-seven cases of tetanus, composed of 36 male and 11 female patients, were reviewed. The mean age of onset was 45.5 years (SD = 19.6 years). Generalized tetanus was the most common form found (91.4%). History of injury or wound was reported in 80.8%. Age over sixty, puncture wound, onset time of less than seven days, and generalized tetanus, significantly correlated with clinical severity. Only two cases died, but the rest of the cases had residual muscle rigidity after treatment.


CONCLUSIONS
The overall clinical features of tetanus and their correlation with the disease severity were presented. Unlike in the past, patients with tetanus can now be reversible under appropriate intensive critical care.
Sathirapanya
Pornchai
P
Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand. sporncha@medicine.psu.ac.th
Sathirapanya
Chutarat
C
Limapichat
Kitti
K
Setthawacharawanich
Suwanna
S
Phabphal
Kanitpong
K
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D008875:Middle Aged; D009125:Muscle Relaxants, Central / Q000627:therapeutic use*; D003473:Neuromuscular Nondepolarizing Agents / Q000627:therapeutic use*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013742:Tetanus / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D013785:Thailand / Q000453:epidemiology; D016896:Treatment Outcome; D055815:Young Adult
D000890:Anti-Infective Agents; D009125:Muscle Relaxants, Central; D003473:Neuromuscular Nondepolarizing Agents