Otero-Maldonado Mariely, Bosques-Rosado Marisel, Soto-Malavé Ruth, Deliz-Roldán Brenda, Bertrán-Pasarell Jorge, Vargas Otero Pedro
Department of Infectious Disease, University of Puerto Rico School of Medicine, San Juan, Puerto Rico.
Bol Asoc Med P R. 2011 Apr-Jun;103(2):41-7.
Tetanus is a very serious disease that can be fatal. Its incidence in the developed world has diminished considerably since the introduction of tetanus toxoid. More importantly, tetanus is one of the few infectious diseases that can be prevented. The recommendations for immunization are clear and readily available. In spite of the progress, we still see cases of tetanus in which the prognosis is poor. We present the case of a 67 year-old man that was admitted to our hospital with one of the most common manifestations of tetanus: trismus. Even though his treatment was established immediately, the hospital stay was long and made him susceptible to various medical complications and nosocomial infections. The incidence of tetanus in Puerto Rico is low but the mortality rate continues to be elevated in the high-risk group: patients older than 60 years of age. This is the reason for which we present this case. Our goal is to provide information with regards to epidemiology, pathogenesis, clinical manifestations, diagnosis and management of tetanus. In addition, it is equally essential to remind our colleagues the significance of adequate prevention of this potentially mortal and disabling disease.
破伤风是一种非常严重的疾病，可能会致命。自引入破伤风类毒素以来，其在发达国家的发病率已大幅下降。更重要的是，破伤风是少数几种可预防的传染病之一。免疫接种的建议明确且易于获取。尽管取得了进展，但我们仍会见到一些破伤风病例，其预后很差。我们报告一例67岁男性患者，他因破伤风最常见的表现之一：牙关紧闭，而入住我院。尽管立即确定了治疗方案，但他住院时间很长，易出现各种医疗并发症和医院感染。波多黎各破伤风的发病率较低，但在高危人群（60岁以上患者）中死亡率仍然很高。这就是我们展示该病例的原因。我们的目标是提供有关破伤风的流行病学、发病机制、临床表现、诊断和管理的信息。此外，同样重要的是要提醒我们的同事充分预防这种潜在致命和致残疾病的重要性。
