Öz
A 26 year-old man who were followed up in a general surgical service as a result of perineal injury was consulted by us due to muscle spasms. The patient was a construction worker and had injured by an iron bar from the perianal region two days ago. In emergency department, tetanus vaccine had been only applied in same day. He was diagnosed as tetanus and admitted to intensive care unit. He was given 5000 U human tetanus ımmune globulin. Intravenous diazepam was given for muscle spasms. Intravenous metronidazole had been applied since the first day of hospitalization. We thought that he might need mechanical ventilation, therefore, patient was referred to another hospital. It was learned that patient had no complications and he was discharged on the 7th day of hospitalization. In conclusion, tetanus is still a problematic infection, although it can be prevented by vaccination. It should kept in mind that tetanus may develop after injury and in addition to tetanus vaccine, application of ımmune globulin is also important
Anahtar Kelimeler
Kaynakça
- Güneysel Ö, Sarıtemur M. Tetanoz: Klinik yaklaşım ve korunma. Akademik Acil Tıp Derg 2006; 4: 48-53.
- Bleck TP, Mandell GL, Bennet JE, Dolin R. Clostridium tetani (Tetanus). Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Disease. 6th ed. Philadelphia: Elsevier, Churchill Livingstone 2005: 2817-22.
- Cook TM, Protheree RT, Handel JM. Tetanus: A reviev of the literature Br J Anesth 2001; 87: 477-87.
- Ergonul O, Erbay A, Eren S, Dokuzoğuz B. Analysis of the case fatality rate of tetanus among adults in a tertiary hospital in Turkey. Eur J Clin Microbiol Infect Dis 2003; 22: 188-90.
- Bartlett JG. Clostridium tetani. In: Gorbach SL, Bartlett JG, Blacklow NR, eds. İnfectious Diseases, 3th ed. Philadelphia. Lippincott Williams & Wilkins 2004: 1796-9.
- Rhee P, Nunley MK, Demetriades D, Velmahos G, Doucet JJ. Tetanus and trauma: A review and recommendations. J Trauma 2005; 58: 1082-8.
- Koruk ST, Söğüt Ö, Karaağaç L, Çalışır C, Yalçın Ş. Unutulmaz hastalık: Çok hızlı seyreden bir tetanoz olgusu. JAEM 2013; 12: 174-7.
Öz
Özet
Perianal bölgesinden yaralanan 26 yaşında erkek hasta genel cerrahi servisinde takip edilirken kasılmaları olması nedeniyle tarafımızdan konsülte edildi. İnşaat işçisi olan hasta iki gün önce perianal bölgeden demir bir çubukla yaralanmış ve aynı gün acil servisde sadece tetanoz aşısı yapılmıştı. Hastaya klinik olarak tetanoz tanısı konuldu ve yoğun bakıma alındı. Hastaya 5000 Ü insan tetanoz immünglobulini uygulandı. Kasılmaları olması nedeniyle diazepam infüzyonu başlandı. Hastaya yatışında metronidazol başlanmıştı ve tedaviye devam edildi. Takibinde mekanik ventilatör ihtiyacı duyabileceği düşünülerek başka bir merkeze sevk edilen hastanın 7 gün takip sonrası komplikasyon gelişmeksizin taburcu edildiği öğrenildi. Sonuç olarak; tetanoz uygun aşılamayla önlenebilmesine rağmen günümüzde hala sorun olan bir enfeksiyondur. Yaralanma sonrası tetanoz gelişebileceği akılda tutulmalı ve tetanoz aşısının yanısıra immünglobulin uygulamasının da yapılması korunma da önemlidir.
Anahtar sözcükler: Tetanoz, kasılma, immünglobulin
Abstract
A 26 year-old man who were followed up in a general surgical service as a result of perineal injury was consulted by us due to muscle spasms. The patient was a construction worker and had injured by an iron bar from the perianal region two days ago. In emergency department, tetanus vaccine had been only applied in same day. He was diagnosed as tetanus and admitted to intensive care unit. He was given 5000 U human tetanus ımmune globulin. Intravenous diazepam was given for muscle spasms. Intravenous metronidazole had been applied since the first day of hospitalization. We thought that he might need mechanical ventilation, therefore, patient was referred to another hospital. It was learned that patient had no complications and he was discharged on the 7th day of hospitalization. In conclusion, tetanus is still a problematic infection, although it can be prevented by vaccination. It should kept in mind that tetanus may develop after injury and in addition to tetanus vaccine, application of ımmune globulin is also important.
Keywords: Tetanus, spasm, ımmune globulin
Anahtar Kelimeler
Kaynakça
- Güneysel Ö, Sarıtemur M. Tetanoz: Klinik yaklaşım ve korunma. Akademik Acil Tıp Derg 2006; 4: 48-53.
- Bleck TP, Mandell GL, Bennet JE, Dolin R. Clostridium tetani (Tetanus). Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Disease. 6th ed. Philadelphia: Elsevier, Churchill Livingstone 2005: 2817-22.
- Cook TM, Protheree RT, Handel JM. Tetanus: A reviev of the literature Br J Anesth 2001; 87: 477-87.
- Ergonul O, Erbay A, Eren S, Dokuzoğuz B. Analysis of the case fatality rate of tetanus among adults in a tertiary hospital in Turkey. Eur J Clin Microbiol Infect Dis 2003; 22: 188-90.
- Bartlett JG. Clostridium tetani. In: Gorbach SL, Bartlett JG, Blacklow NR, eds. İnfectious Diseases, 3th ed. Philadelphia. Lippincott Williams & Wilkins 2004: 1796-9.
- Rhee P, Nunley MK, Demetriades D, Velmahos G, Doucet JJ. Tetanus and trauma: A review and recommendations. J Trauma 2005; 58: 1082-8.
- Koruk ST, Söğüt Ö, Karaağaç L, Çalışır C, Yalçın Ş. Unutulmaz hastalık: Çok hızlı seyreden bir tetanoz olgusu. JAEM 2013; 12: 174-7.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Bölüm | Olgu Sunumları |
| Yazarlar | |
| Yayımlanma Tarihi | 30 Aralık 2014 |
| Yayımlandığı Sayı | Yıl 2014Cilt: 36 Sayı: 4 |