[Clinical aspects and therapy of tetanus]

The various clinical symptoms of the tetanus are included by the Authors in three different groups. In the first and the second ones are the localized forms or tetanus, which affects several skeletal muscle groups without involvement of the respiratory apparatus. In the third group, in addition to the tetanus of the new-born babies, are the most severe forms of tetanus, the dangerousness of which is due to a respiratory involvement or to the persistence of a severe hypertensive-hypotensive syndrome, associated with hyperpyrexia and an ingravescent uncontrollable circulatory failure, in the completely sedated patient. An encephalopathic coma may also occur. The highest mortality (55-70 per cent) is observed in the tetanuses of the third group. The therapy is based on the triad seroanatoxins, antibiotics and sedative drugs. Tracheotomy and assisted mechanical ventilation are essential in the patients of the third group in order to be allowed to administer curare-like drugs as choice remedy. But, in spite of all these heroic treatments, the mortality is still high.