Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, 1129 Nagaoka, Izunokuni City, Shizuoka, 410-2295, Japan.
BMC Infect Dis. 2020 Oct 7;20(1):731. doi: 10.1186/s12879-020-05455-z.
The specific clinical feature of tetanus is whole body muscle spasms. These spasms are intensely painful and sometime lead to some injuries. Vertebral fractures have been reported as a common complication of tetanus, however iliopsoas hematoma is a rare complication. We describe a case of iliopsoas hematoma in a tetanus patient who had not been treated with any anticoagulant or antiplatelet agents.
A 72-year-old female patient was transferred to our hospital 7 days after the onset of tetanus. An iliopsoas hematoma was identified in her right iliopsoas muscle on computed tomography. There was no extravasation; thus, the hematoma improved with conservative therapy. There were no episodes that suggested a bleeding tendency, or no factors associated with hemorrhagic conditions.
This is the first report of iliopsoas hematoma as a complication in a tetanus patient who did not received anticoagulation therapy. The possibility of IPH as a complication of tetanus should be considered before and during the administration of anticoagulation therapy.
破伤风的具体临床特征是全身肌肉痉挛。这些痉挛非常疼痛，有时会导致一些损伤。椎体骨折已被报道为破伤风的常见并发症，然而，髂腰肌血肿是一种罕见的并发症。我们描述了一例未使用任何抗凝或抗血小板药物的破伤风患者的髂腰肌血肿。
一名 72 岁女性患者在破伤风发病后 7 天转入我院。CT 显示其右侧髂腰肌内存在髂腰肌血肿。未见外渗；因此，血肿通过保守治疗得到改善。没有提示出血倾向的发作，也没有与出血情况相关的因素。
这是首例未接受抗凝治疗的破伤风患者并发髂腰肌血肿的报告。在给予抗凝治疗之前和期间，应考虑髂腰肌血肿作为破伤风并发症的可能性。
