Luisto M, Iivanainen M
Department of Neurology, Käpylä Rehabilitation Centre, Helsinki, Finland.
Dev Med Child Neurol. 1993 Apr;35(4):351-5. doi: 10.1111/j.1469-8749.1993.tb11648.x.
Five children aged five to 15 years contracted tetanus in Finland between 1969 and 1985, together with 101 adults. Four of the five had been adequately immunized against tetanus. The clinical picture of tetanus was mild or moderate, and none of the children needed respirator treatment. Epilepsy, meningitis and psychogenic symptoms were considered in the differential diagnosis. The course of tetanus in immunized patients is atypical and often benign, but the diagnosis is problematic--in contrast to affected children in developing countries, whose populations are not adequately immunized and where neonatal tetanus is common and often fatal.
1969年至1985年间,芬兰有5名5至15岁的儿童感染了破伤风,另有101名成年人感染。这5名儿童中有4名已接受过充分的破伤风免疫接种。破伤风的临床表现为轻度或中度,没有一个儿童需要呼吸机治疗。鉴别诊断时考虑了癫痫、脑膜炎和精神症状。免疫接种患者的破伤风病程不典型且通常为良性,但诊断存在问题——与发展中国家受影响的儿童形成对比,在发展中国家,人群未得到充分免疫接种,新生儿破伤风很常见且往往致命。