Tétanos associé aux soins: à propos d’un cas

Tetanus prophylaxis in routine wound management is a major strategy for tetanus prevention in health care settings. Failed wound management interventions leave patient dangerously exposed to this disease. We report the case of a patient with tetanus occurred after medical treatment for head injury performed in a healthcare facility without appropriate tetanus prophylaxis. This study aims to remind clinicians of the importance of prophylaxis in previously unvaccinated wounded patients or with a doubtful immune status. A 52-year-old patient who had not previously been vaccinated against tetanus was admitted to Yalgado Ouédraogo University Hospital CHU/YO with cervical pain, dysphagia, difficulty walking and opening the mouth. The patient had a personal history of deep wound on his forehead sutured without previous anti-tetanus prophylaxis approximately three weeks before. Physical examination on admission showed loose lockjaw, abdominal spasm, dysphagia, a body temperature of 36,5 °C and a scar on his forehead measuring about 7 cm. The diagnosis of generalized tetanus (stage II) infection occurring after forehead wound was retained. Treatment outcome was favorable and the patient was dismissed on September 18, 2015. The prevention of tetanus associated with an appropriate treatment requires rigorous application of aseptic techniques, systematization of antitetanus serum therapy in the management of previously unvaccinated patients or with a doubtful immune status presenting with a deep wound.