Tetanus in adults: a review of 85 cases at Chon Buri Hospital

From 1988 to 1999, 85 cases of adult tetanus were admitted to the medical service of Chon Buri Hospital. The male to female ratio was 2.2:1. In 50 patients disease was severe enough to require paralysis and artificial ventilation. Fourteen patients needed diazepam and artificial ventilation but not paralysis; and in twenty-one the condition was mild, requiring diazepam only. Eleven patients died, all of them had severe grade of tetanus. The mortality rate was 12.9 per cent. In 70 patients a wound was the source of infection, most of which were minor, often receiving no medical attention. No wounds or obvious source of infection could be found in 15 patients. Tetanus is a preventable disease. The treatment of tetanus is time-consuming and costly and there is still a considerable mortality rate. In moderate to severe cases, the patients usually have to spend three to four weeks in an intensive care unit.