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Tetanus in i.v. heroin users.

N Iqbal1

  • 1Al Amal Hospital, Jeddah, Saudi Arabia.

Annals of Saudi Medicine
|January 31, 2007
PubMed
Summary
This summary is machine-generated.

Tetanus cases in intravenous drug users may be increasing, particularly from contaminated heroin. Early misdiagnosis is common, highlighting the need for heightened awareness and suspicion in this vulnerable population.

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Area of Science:

  • Infectious Diseases
  • Toxicology
  • Public Health

Background:

  • Tetanus incidence is declining globally but may be rising in intravenous drug users due to contaminated heroin.
  • No prior reports of tetanus in intravenous drug users (IVDUs) from Saudi Arabia.

Purpose of the Study:

  • To report on cases of tetanus in IVDUs in Saudi Arabia.
  • To emphasize the importance of recognizing tetanus in this demographic.

Main Methods:

  • Retrospective case series of five patients diagnosed with tetanus between October 1997 and September 2000.
  • Analysis of patient presentations, treatments, and diagnostic challenges.

Main Results:

  • All five patients were intravenous heroin users presenting with generalized tetanus symptoms including neck stiffness, opisthotonos, and muscle spasms.

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  • Three patients experienced trismus and autonomic instability.
  • Two cases were initially misdiagnosed by emergency services, with diagnosis delayed due to presentation mimicking neuroleptic side effects.

    • Conclusions:

    • Tetanus is a clinical diagnosis that requires a high index of suspicion in IV drug users.
    • Vigilance is crucial to avoid misdiagnosis, especially in vulnerable populations where the disorder may be more frequent.
    • These findings underscore the need for increased awareness of tetanus in IVDUs.