Trauma-induced tetanus: case series and an up-to-date pharmacoeconomic overview in Nepal

Tetanus is an acute, fatal, and vaccine-preventable infectious disease which is caused by anaerobic bacteria Clostridium tetani. This case series emphasizes on the importance of vaccine, and impact of financial status in the recovery of the patient and pharmacotherapeutic review of tetanus.

This case series was performed at the Department of Internal Medicine at a Tertiary Teaching Hospital. The authors here report two cases of rare and fatal tetanus that were diagnosed clinically, their treatment modality, and impact of socioeconomic status on the prognosis. The authors also review different pharmacotherapeutic modalities of tetanus.

Tetanus is a fatal disease, which requires antitoxin measures, spasm control, and airway management. The treatment of this disease requires prolonged; intensive care unit stay which also increases the incidences of other comorbid fatal conditions like pneumonia. This case series presents cases of 39-years-old male and 41-years-old male who presented to the hospital after cut injury, however financial constraints of 41 years old male made him withdraw from ventilator support whereas 39-years-old male had good recovery due to his better financial status and immunoglobulin access in time.

In this study, we describe the clinical history of a rare and fatal but vaccine-preventable condition, tetanus associated with comorbidities, in an adult male who was successfully treated and another who chose to discontinue treatment due to financial constraints, resulting in death.