Rydström Gustav, Nordh Johan, Pålsson Birger
ST-läkare, medicin-kliniken, Centrallasarettet Växjö.
specia-listläkare, infektionskliniken, Centrallasarettet Växjö.
Lakartidningen. 2021 Nov 26;118:21100.
Tetanus (lockjaw) is a potentially life-threatening disease caused by a neurotoxin produced by the spore forming bacterium Clostridium tetani. The incidence has decreased substantially the last decades in most high-income countries, much due to well established vaccination programs. However, although uncommon, tetanus still remains a reality in Sweden. The condition is diagnosed based on clinical parameters and is hard to distinguish from many other more common differential diagnoses. Lack of vaccine induced antibodies is the most important risk factor for developing tetanus. Here we present a patient who developed tetanus two weeks following a puncture wound, but who was initially misdiagnosed with wake-up stroke. The case illustrates the importance of reviewing a patient's tetanus vaccine history, which determines what prophylactic measures are adequate to take, especially following potentially contaminated wounds.
破伤风（牙关紧闭症）是一种由产芽孢细菌破伤风梭菌产生的神经毒素引起的潜在危及生命的疾病。在过去几十年里，大多数高收入国家的破伤风发病率已大幅下降，这很大程度上归功于完善的疫苗接种计划。然而，尽管破伤风在瑞典并不常见，但仍是一个现实问题。该病根据临床参数进行诊断，且很难与许多其他更常见的鉴别诊断区分开来。缺乏疫苗诱导抗体是发生破伤风的最重要危险因素。在此，我们报告一名患者，其在刺伤后两周发生破伤风，但最初被误诊为苏醒期卒中。该病例说明了回顾患者破伤风疫苗接种史的重要性，这决定了采取何种适当的预防措施，尤其是在伤口可能被污染之后。
