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闭合性骨折传统治疗的一种罕见并发症——全身性破伤风:一例病例报告。

An unusual complication of the traditional treatment of a closed fracture - generalized tetanus: a case report.

作者信息

Tchuenkam Landry W, Ndame Emmanuel K, Guifo Marc L, Danwang Celestin, Kalla Ginette C, Essomba Arthur

机构信息

Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon.

Department of Surgery and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde University Hospital Center, Yaounde, Cameroon.

出版信息

J Med Case Rep. 2017 Oct 24;11(1):298. doi: 10.1186/s13256-017-1477-y.

Abstract

BACKGROUND

Tetanus is a severe infectious disease that can lead to death. The clinical manifestations are due to an exotoxin secreted by Clostridium tetani, a spore-producing Gram-positive bacillus. The penetration of the germ is made through a skin opening, independently of the size of the wound.

CASE PRESENTATION

A 13-year-old black African boy of the Bantu ethnic group with unknown tetanus vaccination status presented to our pediatric emergency room for the management of chest and vertebral pains which started a few days after traditional treatment by scarification and herbal and leaf ointment. The treatment was initiated by a traditional healer and indicated for a closed fracture of our patient's left forearm sustained during a fight. The diagnosis of generalized tetanus was made on the basis of generalized contractures with opisthotonus, trismus, and autonomic nervous system dysfunction. Despite prompt intensive care management, he died a few hours after admission.

CONCLUSION

This case emphasizes the permanent threat of tetanus in our environment especially after cultural and traditional acts like scarification that in this specific case was for a therapeutic purpose.

摘要

背景

破伤风是一种可导致死亡的严重传染病。其临床表现是由破伤风梭菌分泌的一种外毒素引起的,破伤风梭菌是一种产芽孢的革兰氏阳性杆菌。细菌通过皮肤伤口侵入,与伤口大小无关。

病例报告

一名13岁的班图族非洲黑人男孩,破伤风疫苗接种情况不明,因在接受划痕、草药和树叶药膏传统治疗几天后出现胸部和脊椎疼痛,前来我们的儿科急诊室就诊。治疗由一名传统治疗师开始,针对患者在一次打斗中造成的左前臂闭合性骨折。根据全身性痉挛、角弓反张、牙关紧闭和自主神经系统功能障碍,诊断为全身性破伤风。尽管立即进行了重症监护管理,但他在入院后数小时死亡。

结论

该病例强调了破伤风在我们所处环境中的持续威胁,尤其是在诸如划痕等文化和传统行为之后,在这个特定案例中划痕是用于治疗目的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c64f/5654018/4c56c29060e9/13256_2017_1477_Fig1_HTML.jpg

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