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[A case of severe tetanus associated with sympathetic overactivity]
H Yoshihara1, K Shigemitu, Y Abe
1Department of Emergency Medicine, Kagoshima University, Japan.
Abstract:
A case of severe tetanus showing clinical features compatible with sympathetic overactivity (SOA) is reported. A 64-year-old man was admitted to our hospital 6 days after injury. The clinical signs of SOA developed on the second day in ICU. Through the clinical investigation of this case, we found out and insisted on some new concepts about the clinical features of SOA. 1. Lability of arterial pressure is parallel to that of catecholamine level in serum. 2. Two different types in SOA were found. One is dominantly lable type of Adrenaline and another is of Noradrenaline. 3. Drawing a sharp line between 2 types by assessment of circulatory data from Swan-Ganz catheter is significant for deciding therapeutic lines.