Neonatal tetanus associated with skin infection.
A 1-week-old infant was brought to a regional hospital with a history of recurrent seizures following lower abdominal septic skin infection. She was found to have neonatal tetanus, and a spatula test was positive. The tetanus infection was associated with a superficial skin infection, common in neonates. Treatment included sedatives (diazepam, chlorpromazine, phenobarbitone and morphine), muscle relaxants, antibiotics and ventilation in the neonatal intensive care unit. Intrathecal and intramuscular immunoglobulin were given, and the wound was treated. The infant recovered, with no seizures by the 16th day from admission, and was off the ventilator by the 18th day. This was shorter than the usual 3 - 4 weeks for neonates with tetanus at the hospital. The question arises whether tetanus immunisation should be considered in infants with skin infections, which frequently occur in the neonatal period.
Department of Paediatrics and Child Health, Witbank Hospital and School of Medicine, Faculty of Health Sciences, University of Pretoria, South Africa. nomdungwa@yahoo.com.
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Maharaj
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Dungwa
D034861:Abdominal Wall; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D000927:Anticonvulsants / Q000008:administration & dosage*; D003646:Debridement / Q000379:methods; D057210:Delayed Diagnosis / Q000009:adverse effects / Q000517:prevention & control; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D007155:Immunologic Factors / Q000008:administration & dosage; D007231:Infant, Newborn; D009336:Necrosis; D012867:Skin / Q000473:pathology*; D012874:Skin Diseases, Infectious / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D013742:Tetanus / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D013743:Tetanus Antitoxin / Q000008:administration & dosage*; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D000927:Anticonvulsants; D006993:Hypnotics and Sedatives; D007155:Immunologic Factors; D013743:Tetanus Antitoxin