Unforeseen complications of tetanus

The National Hospital for Tropical Diseases recently provided timely treatment to a male patient with tetanus who showed no signs of wounds or abrasions on his body.

Patient LV S, a 65-year-old male from Hai Duong , had no prior health issues and showed no signs of wounds or abrasions on his body.

However, 10 days prior to hospitalization, the patient began experiencing a sore throat but no fever. Upon examination at a medical facility, the patient was diagnosed with acute pharyngitis and prescribed outpatient treatment.

After 6 days of taking the medication, the patient developed unusual symptoms such as difficulty opening his mouth, difficulty speaking, and poor appetite. Recognizing the worsening symptoms, the family took him to a medical facility. There, he was diagnosed with tetanus and transferred to the National Hospital for Tropical Diseases.

At the Emergency Department of the National Hospital for Tropical Diseases, the patient's initial condition was quite alert, without fever or seizures, but with limited ability to open their mouth, only about 1 cm.

The doctors are examining the patient.

Notably, the patient exhibited marked increased muscle tone (spasms) in the abdomen and throughout the body. Particularly with mechanical stimulation such as touch, the muscles reacted strongly, manifesting as spasms and rigidity. Based on these initial symptoms, the patient was diagnosed with generalized tetanus. Currently, the patient is sedated and ventilated via endotracheal tube.

According to MSc. Nguyen Thanh Bang, from the Emergency Department of the Central Hospital for Tropical Diseases, in patient S.'s case, no external wounds or signs of trauma were found that could potentially be entry points for tetanus spores.

Typically, tetanus bacteria enter the body through open wounds, injuries, or surgery.

However, when patients cannot clearly identify the entry point of the wound, the risk of tetanus infection can still come from small scratches sustained during previous work or daily activities that the patient may not notice, because tetanus has a long incubation period, so patients may not remember the exact cause.

There are reports that tetanus occurs after oral infections, such as tooth decay, tooth extraction, periodontal abscess, etc.

In patient S.'s case, we suspect the tetanus originated from the oral cavity. Additionally, in rare cases, tetanus bacteria can enter through lesions or infections in the intestines, such as from surgical incisions during endoscopy or minor lesions in the stomach, rectum, or anus.”

Therefore, early recognition of suspicious signs (progressive jaw stiffness, muscle spasms) and implementation of appropriate preventive measures are key factors in protecting health and preventing serious disease progression.

Doctor Bang advises that those working in agriculture or manual labor, who frequently come into contact with the ground, should get regular tetanus vaccinations and take protective measures while working to minimize the risk of injuries.

Furthermore, any wound on the body, no matter how small, needs to be treated properly. Deep, dirty wounds should be treated at medical facilities, and open wounds should not be allowed to come into contact with mud or dirt. General oral hygiene should also be ensured.

If symptoms such as difficulty opening the mouth, difficulty speaking, or difficulty eating appear, patients should immediately go to a medical facility for examination and early diagnosis.