1/7. Localized tetanus in a child.The majority of physicians in practice today in developed countries have never seen a case of tetanus. The last pediatric case reported in canada occurred in 1992. We present the case of a child who had localized tetanus despite previous partial immunization.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/7. Tetanus: a case report, epidemiology review and recommendations for immunization compliance.Tetanus is a forgotten disease in the united states since many practicing primary care physicians have not seen a case of the disease in their career. A 73-year-old woman presented with dysphagia two weeks after she obtained a superficial laceration while gardening. Within days, the jaw spasms and subsequent respiratory compromise that necessitated five weeks of ventilator support revealed the devastation that this disease can cause. Tetanus spores are found in high concentration in the soils of rural areas, especially where farm animals have grazed. Populations most at risk in the U.S. include under- or non-immunized elderly and immigrant populations. Barriers to immunization include patient and physician non-compliance, missed opportunity for immunization and concern over vaccine side effects. Targeting high-risk groups will enable primary care physicians to be more proactive in providing immunization, and thus in preventing prevention this disease.- - - - - - - - - - ranking = 3keywords = physician (Clic here for more details about this article) |
3/7. Tetanus. A threat to elderly patients.Tetanus rarely occurs in young persons now that childhood immunization programs are widespread. Many older patients, however, are not completely immunized, and mortality in this group is high. Since many of the wounds from which tetanus arises are minor, patients may not bring them to medical attention. Thus, physicians should include assessment of immunization status during routine office visits in all age-groups and provide immunization against tetanus and against diphtheria if indicated.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
4/7. Tetanus.Tetanus is a preventable disease with proper immunization. The marked decline in the incidence over the past several decades has resulted from widespread use of tetanus prophylaxis and improved wound management in the emergency department. Emergency physicians are among the most frequent providers of tetanus vaccination. We can stress the importance of proper immunization and encourage patients to keep accurate immunization records. This can maximize protection of patients from tetanus, and minimize adverse reactions from excessive administration of booster. Tetanus can be fatal even with proper treatment. Vital treatment measures can easily be completed in the emergency department.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
5/7. Mechanical cornpicker hand injuries.The mechanical cornpicker causes tearing anse injuries from 1962 to 1975 were studied with regard to mechanism and extent ohe time of injury in 36% of hands, and in 73% of the remainder following treatmophylaxis, and antibiotics, and 73% hands required some form of delayed surgical treatment. Antibiotics did not appear to be helpful. Eighty-nine ps the most common cause given for farmers for their injuries. Excluding four pr permanently disabled patients, the average length of disability was 135 days. Eighty-nine per cent of patients experienced some permanent impairment of hand function. The mechanical cornpicker is described, and the importance of its proper use and physician's emphasis on accident prevention as well as treatment are stressed.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
6/7. Elevated antitoxin titers in a man with generalized tetanus.vaccination programs have significantly reduced the incidence of tetanus in the united states. The disease develops almost exclusively in those who have been inadequately immunized. This report describes severe, generalized tetanus in a 29-year-old man who had received a primary series as a child and two booster injections. serum obtained before administration of tetanus immune globulin showed antibody titers to tetanus greater than 100 times the level considered protective. Aggressive supportive care can usually prevent serious consequences. Since most physicians have never seen a case of tetanus, however, the diagnosis can be difficult. Many disorders that exhibit signs and symptoms similar to tetanus must be carefully considered during the evaluation of these patients. Tetanus is a preventable disease. Prevention, however, requires both appropriate immunizations and prompt wound care. While controversy exists regarding the most effective policy to adequately immunize all individuals, this case shows that vaccination alone does not preclude the possibility of tetanus.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
7/7. Neonatal tetanus in the united states: a sentinel event in the foreign-born.BACKGROUND: Neonatal tetanus occurred in a 7-day-old infant born to Mexican immigrant parents in tennessee in February, 1995. This was the first patient with neonatal tetanus reported in the united states since 1989. methods: We interviewed the infant's mother and physicians and reviewed the medical record. We conducted a telephone survey of 103 (17%) of the 609 licensed obstetrician/gynecologists practicing in tennessee to assess vaccination history-taking practices during prenatal care. RESULTS: The mother was a 30-year-old gravida 4 para 3 woman who grew up in rural mexico. After moving to the united states in 1987, she had delivered two children before this delivery. The hospital-based delivery and nursery stay in February, 1995, were uncomplicated. On the sixth day of life the infant became irritable and developed muscle stiffness. The next day he was examined by a pediatrician who diagnosed neonatal tetanus. The infant recovered fully after a 2-month hospitalization. The survey of obstetrical practices revealed that 61 (59%) of 103 respondents asked about the patient's vaccination status during prenatal care. However, of all respondents, only 14 (14%) confirmed that they specifically asked about prior tetanus vaccinations. tetanus toxoid was available in 47% of offices on the day of the survey. CONCLUSIONS: Neonatal tetanus can still occur in the united states. This infant's immigrant mother had multiple missed opportunities to be vaccinated against tetanus during her three pregnancies in this country. health care providers should ask patients about their vaccination status, particularly those patients who are foreign-born or who grew up outside the united states.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |