Akdur O, Ozkan S, Durukan P, Koyuncu M, Ikizceli I, Metan G
Department of Emergency Medicine, Erciyes University Faculty of Medicine, Kayseri, Turkey.
Bratisl Lek Listy. 2011;112(8):469-71.
Tetanus is a serious and acute life-threatening disease caused by toxins of "Clostridium tetani". Although it is generally a disease of developing countries, its lower incidence is encountered also in developed countries. Since the principal treatment of this disease is known to be based on vaccination and wound care, the emergency physicians play a key role in its management.
In the present study, we reviewed its uncommon clinical course along with demographic and clinical features of five cases that have presented with various complaints to our Emergency Department. Presenting signs, demographic features, injury history, and the time from the occurrence of injury to the beginning of symptoms were evaluated.
Four of five cases were female. The mean age of cases was 56.8 (34-73). Three of them had hand injury, one had foot injury, and the fifth case had facial injury. The initial symptoms included difficult jaw movement, back muscle spasm, and pain. Two cases died.
Tetanus cases may present to ED with different symptoms. Therefore, physicians should be aware of the early signs of tetanus. Careful and meticulous wound management of cases presented to ED following an injury should be considered a significant factor, which can help in reducing the tetanus cases (Tab. 2, Ref. 18).
破伤风是由破伤风梭菌毒素引起的一种严重的急性危及生命的疾病。尽管它通常是发展中国家的疾病，但在发达国家也有较低的发病率。由于已知这种疾病的主要治疗方法是基于疫苗接种和伤口护理，急诊医生在其管理中起着关键作用。
在本研究中，我们回顾了5例因各种主诉就诊于我院急诊科患者的不常见临床病程以及人口统计学和临床特征。对患者的症状表现、人口统计学特征、受伤史以及从受伤到症状出现的时间进行了评估。
5例患者中有4例为女性。患者的平均年龄为56.8岁（34 - 73岁）。其中3例手部受伤，1例足部受伤，第5例面部受伤。初始症状包括牙关活动困难、背部肌肉痉挛和疼痛。2例死亡。
破伤风病例可能以不同症状就诊于急诊科。因此，医生应了解破伤风的早期症状。对于受伤后就诊于急诊科的患者，仔细而细致的伤口处理应被视为一个重要因素，这有助于减少破伤风病例（表2，参考文献18）。
