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破伤风:一种可通过免疫预防的疾病

[Tetanus: an immunopreventable disease].

作者信息

Lamberto Yésica, Vargas Cristian, Sanchez Cunto Milagro, Saúl Pablo, Chediack Viviana, Cunto Eleonora

机构信息

Departamento de Terapia Intensiva-DAIPIC, Pabellón R Koch, Hospital de Infecciosas Francisco J. Muñiz, Buenos Aires, Argentina. E-mail:

Departamento de Terapia Intensiva-DAIPIC, Pabellón R Koch, Hospital de Infecciosas Francisco J. Muñiz, Buenos Aires, Argentina.

出版信息

Medicina (B Aires). 2023;83(5):841-845.

Abstract

Tetanus is an infectious disease caused by a ubiquitous bacterium Clostridium tetani, that synthesizes and releasesa potent neurotoxin under anaerobic conditions, which is responsible for the clinical manifestations. As it is found in soil contaminated with animal and human excreta, it is difficult to eradicate but it may be prevented by immunization. Immunization rate has decreased in the last years, especially during the COVID-19 pandemic. We report two cases of tetanus, attended during 2022. A 39-year-old man whose entry route was a gunshot wound and he was discharged from the intensive care unit (ICU) and a second case of an 83-year-old woman with unknown entry point, who died during her ICU stay. The cases reported highlight that it is a life-threatening disease, its diagnosis is mainly clinical and it should be in the algorithm of differential diagnoses. We emphasize about the prompt treatment administration or consultation to a specialized healthcare center. The importance of this presentation is to show the severity of the disease, whose assessment is mainly clinical and should not escape the algorithm of differential diagnoses, emphasizing that treatment should be instituted early or when in doubt consult a specialized center. In addition to this, it is important to check theimmunization rate in our country, especially during thepandemic, becauseit is a vaccine-preventable disease.

摘要

破伤风是一种由无处不在的破伤风梭菌引起的传染病,该细菌在厌氧条件下合成并释放一种强效神经毒素,这是导致临床表现的原因。由于它存在于被动物和人类排泄物污染的土壤中,难以根除,但可通过免疫接种预防。在过去几年中,免疫接种率有所下降,尤其是在新冠疫情期间。我们报告了2022年接诊的两例破伤风病例。一例是一名39岁男性,感染途径为枪伤,已从重症监护病房(ICU)出院;另一例是一名83岁女性,感染途径不明,在ICU住院期间死亡。报告的病例凸显了这是一种危及生命的疾病,其诊断主要基于临床,应纳入鉴别诊断流程。我们强调应及时进行治疗或咨询专业医疗中心。本报告的重要性在于展示该疾病的严重性,其评估主要基于临床,不应脱离鉴别诊断流程,强调应尽早开始治疗,如有疑问应咨询专业中心。除此之外,检查我国的免疫接种率很重要,尤其是在疫情期间,因为这是一种可通过疫苗预防的疾病。

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