Generalised tetanus: the San Lazaro Hospital experience

Tetanus is a devastating toxin-mediated neurological disease that continues to exact high mortality in resource-constrained settings despite an effective and inexpensive vaccine. With just 10 cases diagnosed in the UK each year, few neurologists will encounter the condition over the course of their career. Nonetheless, a working knowledge of its clinical features, staging and management remains important, given the positive clinical outcomes that can be achieved through prompt recognition and aggressive treatment, even in older, comorbid patients. Here, we describe two cases of generalised tetanus in adults presenting to the apex hospital for infectious diseases in Metro Manila, the Philippines, and outline practical steps for clinical management.