Ichlasul Mahdi Fardhani
Faculty of Medicine, University of Jember, Jember, Indonesia

Muhammad Isra Rafidin Rayyan
Faculty of Medicine, University of Jember, Jember, Indonesia

DOI: https://doi.org/10.19184/ams.v10i2.47191

Abstract

Tetanus is an infectious disease with a high mortality rate caused by the bacterium Clostridium tetani. Although it can be prevented through vaccination, tetanus is still a significant problem, especially in developing countries, so comprehensive treatment is needed to prevent more fatal complications. A 52-year-old male patient was referred to our hospital's Emergency Department with stiffness of the jaw, neck and abdomen three days ago. The patient was diagnosed with tetanus after being hit by a tree thorn and developed risus sardonicus, trismus, and opisthotonus, which could not be controlled with benzodiazepines. The patient developed autonomic dysfunction, resulting in bradycardia, tachycardia, and fluctuating blood pressure. The patient was treated for more than 30 days in the intensive care unit with a mechanical ventilator, immunoglobulin, antibiotics, anti-spasm, and sedatives. In addition, the patient was also infected with Pseudomonas aeruginosa pneumonia during the treatment period. Finally, the patient was successfully treated and discharged. This case report highlights the importance of multidisciplinary care in the ICU in diagnosing and treating tetanus patients, which is expected to provide the best outcomes for patients.

Keyword: Case report; refractory spasm; generalized tetanus; neuroinfectious disease; pneumonia.

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