title: [Clinical and epidemiological profile of accidental tetanus cases in Ribeirão Preto in the State of São Paulo from 1990 to 2009].
abstract: BACKGROUND
  Tetanus remains a major health problem in developing countries. In Brazil, despite technological advances, no significant decrease in the lethality rate of tetanus have been documented in recent years. Clinical and epidemiological data from patients who were treated in Ribeirão Preto in the state of São Paulo, Brazil in the last two decades were analyzed in this case series.
  
  
  METHODS
  Retrospective data regarding the demographics, clinical presentations and prognoses of patients admitted with clinical suspicion of tetanus to a tertiary referral university hospital from 1990 to 2009 were identified. The tetanus diagnosis was defined according to the Brazilian Ministry of Health criteria.
  
  
  RESULTS
  Eleven cases out of 23 patients with suspected tetanus were included in this study (47.8% of positive cases). The Tetanus Severity Score ranged from 0 to 8 points. There were no deaths, but two (18.2%) patients had permanent neurological deficits. The median length of hospital stay was 17 days (6-98 days). The absence of deaths can be explained by early clinical diagnosis and prompt treatment.
  
  
  CONCLUSIONS
  Ribeirão Preto is an area in which tetanus is not a severe public health problem.
authors.affiliation: Departamento de Medicina, Universidade Federal de São Carlos, São Carlos, SP. fabioneves@ufscar.br
authors.forename: Fábio Fernandes
authors.initials: FF
authors.lastname: Neves
authors.forename: Rivian Christina Lopes
authors.initials: RC
authors.lastname: Faiolla
authors.forename: Emília Maria Guimarães de
authors.initials: EM
authors.lastname: Napoli
authors.forename: Geovana Momo Nogueira de
authors.initials: GM
authors.lastname: Lima
authors.forename: Renata Zomer de Albernaz
authors.initials: RZ
authors.lastname: Muniz
authors.forename: Antônio
authors.initials: A
authors.lastname: Pazin-Filho
mesh_terms: D000059:Accidents / Q000706:statistics & numerical data*; D000328:Adult; D000368:Aged; D001938:Brazil / Q000453:epidemiology; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013742:Tetanus / Q000175:diagnosis / Q000453:epidemiology*; D014505:Urban Population