Taniyama Daisuke, Yamamoto Ryusuke, Uwamino Yoshifumi, Kitahara Mitsuo
Department of General Internal Medicine, Tokyo Saiseikai Central Hospital.
Kansenshogaku Zasshi. 2013 May;87(3):385-8. doi: 10.11150/kansenshogakuzasshi.87.385.
We report herein on a rare case of tetanus originating from ulcerated breast cancer. A 60-year-old homeless woman was admitted to our hospital because of lockjaw. On admission, a physical examination revealed tachypnea, trismus, opisthotonus and an ulcerated right breast. There was no other skin soft tissue damage. A diagnosis of tetanus was entertained from the lockjaw and opisthotonus. Tetanus globulin, tetanus toxoid, penicillin and respiratory support were initiated. Later, a right total mastectomy was performed, and the diagnosis of breast cancer was made, however, gram positive bacilli were not detected and Clostridiuum tetani (C. tetani) was not cultured. It is conceivable that the ulcerated breast was contaminated with C. tetani due to the patients living conditions.
我们在此报告一例罕见的源自溃疡性乳腺癌的破伤风病例。一名60岁的无家可归女性因牙关紧闭入院。入院时,体格检查发现呼吸急促、牙关紧闭、角弓反张以及右侧乳腺溃疡。无其他皮肤软组织损伤。根据牙关紧闭和角弓反张考虑破伤风诊断。给予破伤风球蛋白、破伤风类毒素、青霉素及呼吸支持治疗。之后,行右侧全乳切除术,确诊为乳腺癌,然而,未检测到革兰氏阳性杆菌,也未培养出破伤风梭菌。鉴于患者的生活条件,推测溃疡性乳腺被破伤风梭菌污染。