Tetanus: A Retrospective Study of Clinical Presentations and Outcomes in a Medical Teaching Hospital
Pornchai Sathirapanya MD*, Chutarat Sathirapanya BSc, MSc, PhD**, Kitti Limapichat MD*, Suwanna Setthawacharawanich MD*, Kanitpong Phabphal MD*
Affiliation : * Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand **Faculty of Health and Sports Sciences, Thaksin University, Maung, Songkhla, Thailand
Background : Tetanus has been a serious infectious disease with high mortality and morbidity. Some clinical
factors can predict its severity.
Objective : Survey the clinical profiles, their correlation with the severity of tetanus and the final outcomes
after treatment.
Material and Method: A retrospective study of the medical records of patients with tetanus who attended
Songklanagarind hospital between January 1982 and June 2008 was done. The correlation between clinical
profiles and severity was analyzed by Fisher exact test to detect the significant correlation (p < 0.05).
Results : Forty-seven cases of tetanus, composed of 36 male and 11 female patients, were reviewed. The mean
age of onset was 45.5 years (SD = 19.6 years). Generalized tetanus was the most common form found (91.4%).
History of injury or wound was reported in 80.8%. Age over sixty, puncture wound, onset time of less than seven
days, and generalized tetanus, significantly correlated with clinical severity. Only two cases died, but the rest
of the cases had residual muscle rigidity after treatment.
Conclusion : The overall clinical features of tetanus and their correlation with the disease severity were
presented. Unlike in the past, patients with tetanus can now be reversible under appropriate intensive critical
care.
Keywords : Prognosis, Tetanus, Treatment outcome
