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An Unusual Case of Tetanus Masquerading as an Acute Abdomen: A Case Report
INTRODUCTION: Tetanus is an acute onset neurological disease that is often lethal. It has a high disease burden in low and middle-income countries. Tetanus is caused by a toxin made by spores of the bacterium Clostridium tetani, which are found in soil, dust, and animal feces. The toxin impairs the...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
University of California Irvine, Department of Emergency Medicine publishing Western Journal of Emergency Medicine
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7676795/ https://www.ncbi.nlm.nih.gov/pubmed/33217282 http://dx.doi.org/10.5811/cpcem.2020.8.49073 |
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author | Thakur, Rahul Kumar Singh, Rajshree Nepal, Sabin Ghimire, Prasanna |
author_facet | Thakur, Rahul Kumar Singh, Rajshree Nepal, Sabin Ghimire, Prasanna |
author_sort | Thakur, Rahul Kumar |
collection | PubMed |
description | INTRODUCTION: Tetanus is an acute onset neurological disease that is often lethal. It has a high disease burden in low and middle-income countries. Tetanus is caused by a toxin made by spores of the bacterium Clostridium tetani, which are found in soil, dust, and animal feces. The toxin impairs the motor neurons leading to muscle stiffness. However, with the development of a toxoid vaccine, the incidence has sharply declined and is now categorized as a vaccine-preventable disease. The treatment of tetanus is primarily supportive and focuses on managing the complications until the effects of toxins resolve. CASE REPORT: We report the case of a 67-year-old farmer who previously sustained a laceration injury approximately 45 days prior to presenting to the emergency department with abdominal pain and rigidity. After a comprehensive evaluation to rule out other items in the differential diagnoses, he was diagnosed with tetanus based on clinical symptoms and ultimately required mechanical ventilation. The patient was then managed in the intensive care unit and later made an uneventful recovery. CONCLUSION: This case illustrates an uncommon presentation of tetanus and the latency of the infectious process. Often when patients present with atypical symptoms, it poses a diagnostic dilemma to the clinicians. Thus, it is very important to carefully elicit a history of contaminated injury. This case also highlights the importance of prophylactic vaccine in low and middle-income countries, which can reduce disease-related mortality and morbidity. |
format | Online Article Text |
id | pubmed-7676795 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | University of California Irvine, Department of Emergency Medicine publishing Western Journal of Emergency Medicine |
record_format | MEDLINE/PubMed |
spelling | pubmed-76767952020-11-24 An Unusual Case of Tetanus Masquerading as an Acute Abdomen: A Case Report Thakur, Rahul Kumar Singh, Rajshree Nepal, Sabin Ghimire, Prasanna Clin Pract Cases Emerg Med Case Report INTRODUCTION: Tetanus is an acute onset neurological disease that is often lethal. It has a high disease burden in low and middle-income countries. Tetanus is caused by a toxin made by spores of the bacterium Clostridium tetani, which are found in soil, dust, and animal feces. The toxin impairs the motor neurons leading to muscle stiffness. However, with the development of a toxoid vaccine, the incidence has sharply declined and is now categorized as a vaccine-preventable disease. The treatment of tetanus is primarily supportive and focuses on managing the complications until the effects of toxins resolve. CASE REPORT: We report the case of a 67-year-old farmer who previously sustained a laceration injury approximately 45 days prior to presenting to the emergency department with abdominal pain and rigidity. After a comprehensive evaluation to rule out other items in the differential diagnoses, he was diagnosed with tetanus based on clinical symptoms and ultimately required mechanical ventilation. The patient was then managed in the intensive care unit and later made an uneventful recovery. CONCLUSION: This case illustrates an uncommon presentation of tetanus and the latency of the infectious process. Often when patients present with atypical symptoms, it poses a diagnostic dilemma to the clinicians. Thus, it is very important to carefully elicit a history of contaminated injury. This case also highlights the importance of prophylactic vaccine in low and middle-income countries, which can reduce disease-related mortality and morbidity. University of California Irvine, Department of Emergency Medicine publishing Western Journal of Emergency Medicine 2020-10-19 /pmc/articles/PMC7676795/ /pubmed/33217282 http://dx.doi.org/10.5811/cpcem.2020.8.49073 Text en Copyright: © 2020 Thakur et al. http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) License. See: http://creativecommons.org/licenses/by/4.0/ |
spellingShingle | Case Report Thakur, Rahul Kumar Singh, Rajshree Nepal, Sabin Ghimire, Prasanna An Unusual Case of Tetanus Masquerading as an Acute Abdomen: A Case Report |
title | An Unusual Case of Tetanus Masquerading as an Acute Abdomen: A Case Report |
title_full | An Unusual Case of Tetanus Masquerading as an Acute Abdomen: A Case Report |
title_fullStr | An Unusual Case of Tetanus Masquerading as an Acute Abdomen: A Case Report |
title_full_unstemmed | An Unusual Case of Tetanus Masquerading as an Acute Abdomen: A Case Report |
title_short | An Unusual Case of Tetanus Masquerading as an Acute Abdomen: A Case Report |
title_sort | unusual case of tetanus masquerading as an acute abdomen: a case report |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7676795/ https://www.ncbi.nlm.nih.gov/pubmed/33217282 http://dx.doi.org/10.5811/cpcem.2020.8.49073 |
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