Bagcı66. Bağcı Z. Cephalic tetanus: a rare case report. J Trop Pediatr. 2020;66:549-52. |
1 patient |
16 months |
Mucosal erosion in right cheek |
Rigidity of jaw, face and neck, salivation |
Unvaccinated |
HTIG, penicillin, metronidazole, midazolam, tetanus toxoid vaccine |
Survived |
Ahmed et al.77. Ahmed BS, Beck MJ, Williamson G, Ericson JE, Kumar P. Pediatric tetanus in Central Pennsylvania. J Pediatric Infect Dis Soc. 2019;8:358-60. |
5 patients |
3 years |
Foot laceration |
Fever, abdominal distention, and back pain |
Unvaccinated |
Exploratory laparotomy, HTIG tetanus toxoid vaccine metronidazole. |
Survived |
|
|
7 years |
Hand laceration |
Trismus, jaw pain, and neck, back, and leg stiffness |
Unvaccinated |
HTIG, tetanus toxoid vaccine, penicillin |
Survived |
|
|
11 years |
Knee laceration |
Trismus, pain, and discharge from wound |
Unvaccinated |
HTIG, tetanus toxoid vaccine, metronidazole cefazolin |
Survived |
|
|
9 years |
Foot splinter |
Trismus and dysphagia |
Unvaccinated |
HTIG tetanus toxoid vaccine. metronidazole |
Survived |
|
|
7 years |
Foot laceration |
Trismus, sore throat, and body stiffness |
Unvaccinated |
Magnesium sulfate, HTIG tetanus toxoid vaccine, metronidazole |
Survived |
Bagcı88. Bağcı Z. Truncal tetanus: a case report. J Trop Pediatr. 2021;67:fmaa129. |
1 patient |
9 years |
Trunk injury |
Chest, abdomen, back muscle stiffness |
Unvaccinated |
HTIG, tetanus toxoid vaccine. metronidazole, baclofen, midazolam, penicillin G |
Survived |
Cejudo-García de Alba et al.99. Cejudo-García de Alba MP, Valle-Leal JG, Sánchez Beltrán JG, Vázquez-Amparano AJ. Tetanus, a current disease in pediatric population: case report. Rev Chil Pediatr. 2017;88:507-10. |
1 patient |
6 years |
Right arm splinter |
Abdominal muscle stiffness, trismus difficulty walking |
Incomplete immunization |
Metronidazole, penicillin, wound debrided, HTIG tetanus toxoid vaccine |
Survived |
Asín et al.1010. Pérez-Jacoiste Asín MA, Langbazounga M. Neonatal tetanus in an African newborn. Int J Infect Dis. 2018;67:1-2. |
1 patient |
7-day-old newborn |
Umbilical cord |
Muscular spasms, Trismus rigidity |
Unvaccinated |
HTIG, metronidazole diazepam, ampicillin gentamicin |
Survived |
Sesama et al.1111. Sesama M, Gomber S, Yadav M. Cephalic tetanus presenting as ptosis. Indian Pediatr. 2020;57:72-3. |
1 patient |
7 years |
Left ear discharge |
Reflex spasm of masseters, left eye ptosis |
Unvaccinated |
Diazepam, ceftriaxone, metronidazole, supportive management, HTIG, diazepam |
Survived |
Akane et al.1212. Akane Y, Tsugawa T, Hori T, Togashi A, Yoto Y, Inazawa N, et al. Tetanus in a partially immunized child. J Infect Chemother. 2018;24:980-2. |
1 patient |
13 years |
Fracture of right distal radius |
Trismus, muscle rigidity, excessive diaphoresis, risus sardonicus |
Partially immunized |
HTIG, tetanus toxoid, metronidazole, diazepam, penicillin G |
Survived |
Douvoyiannis et al.1313. Douvoyiannis M, Belamarich PF, Goldman DL. Tetanus after vaccine refusal and an opportunity for the pediatric infectious diseases specialist. Clin Pediatr (Phila). 2015;54:513-6. |
1 patient |
9 years |
Nail |
Painful neck stiffness, lockjaw |
Unvaccinated |
HTIG, tetanus toxoid, midazolam |
Survived |
Homola et al.1414. Homola L, Klučka J, Helešic J, Jirsenská Z, Kratochvíl M, Dominik P, et al. Unvaccinated child tetanus from nasal toy battery. Cent Eur J Public Health. 2021;29:322-4. |
1 patient |
2 and a half years |
Deep erosion in the nasal mucosa, nasal toy |
Difficulty swallowing trismus |
Unvaccinated |
Clindamycin, metronidazole, HTIG, tetanus toxoid |
Survived |
Condé et al.1515. Condé I, Cherif MS, Dahal P, Hyjazi ME, Camara F, Diaby M, et al. Neonatal and postneonatal tetanus at a referral hospital in Kamsar, Guinea: a retrospective audit of paediatric records (2014-2018). Int Health. 2022;14:468-74. |
39 patients |
13 days (median age) |
Post-circumcision: 2 Umbilical cord: 20 Wound: 12 Limb fracture: 1 |
Fever, generalized muscle spasm, trismus |
Unvaccinated: 17 Received 1 dose: 19 Received 2 doses: 3 |
NR |
Died (n=20) Survived (n=19) |
Maharaj et al.1616. Maharaj M, Dungwa N. Neonatal tetanus associated with skin infection. S Afr Med J. 2016;106:888-90. |
1 patient |
1 week |
Lower abdominal skin infection |
NR |
Unvaccinated |
Sedatives, muscle relaxants, antibiotics, intrathecal / intramuscular immunoglobulin, wound treatment |
Survived |
Nakubulwa et al.1717. Nakubulwa C, Opio E, Alekat GS, Kibetenga M, Alaroker FO. Neonatal tetanus with good outcomes at a regional referral hospital in Eastern Uganda: a case report. J Med Case Rep. 2022;16:54. |
1 patient |
9 days |
None |
Labile heart rate, tachypnea, hyperpyrexia, abdominal muscle rigidity, generalized spasms |
Maternal partially immunized |
Cefotaxime, gentamicin, metronidazole, diazepam, magnesium sulfate, equine tetanus antitoxin |
Survived |
Okidi et al.1818. Okidi R, Sambo VD, Eyul J. Neonatal tetanus in St. Mary’s Hospital Lacor: a case report. Clin Case Rep. 2020;8:2234-6. |
1 patient |
5-day-old neonate |
NR |
Fever, refusal to breastfeed, excessive crying, difficulty in breathing |
Unvaccinated |
Diazepam, metronidazole, phenobarbital |
Died |
Tadele et al.1919. Tadele H. Clinical profile and outcome of pediatrics tetanus: the experience of a tertiary hospital in Ethiopia. Ethiop J Health Sci. 2017;27:559-64. |
24 patients |
8 years (median age) |
Trauma Tungiasis |
Generalized tetanus symptoms |
Maternal partially immunized |
Diazepam, chlorpromazine, debridement, penicillin G, metronidazole, tetanus toxoid |
Survived (n=17) Died (n=7) |
Ogunkeyede et al.2020. Ogunkeyede SA, Daniel A, Ogundoyin O. Paediatric otogenic tetanus: an evidence of poor immunization in Nigeria. Pan Afr Med J. 2017;26:177. |
23 patients |
3.4 years |
Otogenic tetanus |
Ear discharge, trismus and spasms |
Complete tetanus immunization (12), unvaccinated (6), partial tetanus immunized (5) |
Topical antibiotic ear dressing, tetanus toxoid, HTIG, antibiotic therapy, sedatives |
Died (n=3) Survived (n=20) |
Barlas et al.2121. Barlas ÜK, Kıhtır HS, Yeşilbaş O, Petmezci MT, Akçay N, Petmezci E, et al. Tetanus, a forgotten infection disease: a report of two cases. Turk J Pediatr. 2020;62:274-9. |
2 patients |
12 years |
Puncture on right foot |
Lock-jaw, facial, abdominal muscle rigidity |
Unvaccinated |
HTIG, tetanus toxoid, metronidazole, diazepam, vancomycin, ceftazidime, rocuronium, baclofen, fentanyl |
Survived |
|
|
6 years |
Puncture on left foot |
Back pain, difficulty in opening the mouth and swallowing |
Unvaccinated |
ampicillin-sulbactam, metronidazole, HTIG, tetanus toxoid, fentanyl, baclofen, midazolam |
Survived |
Aqeel et al.2222. Aqeel AY, Arishi HM, Ageel HI, Arishi NH. Epidemiological and clinical aspects of neonatal tetanus from a tertiary care hospital. Int J Pediatr Adolesc Med. 2017;4:71-4. |
30 patients |
Neonate |
Unhealthy umbilical stump |
Muscle spasm, refusal to eat, abnormal posture |
Maternal unvaccinated: 27 Maternal partially immunized: 3 |
HTIG, penicillin G, gentamicin, muscle relaxant pavulon |
Died (n=6) Survived (n=24) |
Irie et al.2323. Irie BG, Asse KV, Kadiane NJ, Kofi N, Nda-Koffi C, Ogondon B, et al. Tetanus after application of traditional topical treatment to a severe burn. Med Sante Trop. 2018;28:446-7. |
1 patient |
2 years |
Severe thermal burn |
Fever, refusal to eat, trismus, generalized contractures |
Unvaccinated |
HTIG, amoxicillin clavulanic acid, benzodiazepine |
Died |
Neal et al.2424. Neal M, Culbertson MC 3rd, Mendiratta S, Smith BC 3rd, Whittle JS. Boy with muscle spasms. Ann Emerg Med. 2017;70:432-40. |
1 patient |
10 years |
Foot puncture |
Muscle spasms, trismus, fever, risus sardonicus, opisthotonus |
Unvaccinated |
Diazepam, metronidazole, HTIG, tetanus toxoid, surgical debridement |
Survived |
Şık et al.2525. Şık G, Aydoseli A, Çıtak A. Intrathecal baclofen use in the management of tetanus related spasm: a case report. Turk J Pediatr. 2019;61:126-9. |
1 patient |
12 years |
Right foot laceration |
Spasms of the right foot, back, tachycardia hypertension, rigidity |
Unvaccinated |
Diazepam, morphine, vecuronium, magnesium sulfate, crystalline penicillin, HTIG, tetanus toxoid, intrathecal baclofen |
Survived |
Felter et al.2626. Felter RA, Zinns LE. Cephalic tetanus in an immunized teenager: an unusual case report. Pediatr Emerg Care. 2015;31:511-3. |
1 patient |
14 years |
Right foot laceration |
Speaking with difficulty, bilateral ptosis, pain, swelling, sternal chest pain with palpitations |
Unvaccinated |
Diazepam, lorazepam, HTIG, tetanus toxoid, metronidazole ciprofloxacin |
Survived |
Gowda et al.2727. Gowda VK, Veerappa BG, Handral A, Benakappa A. Re-emergence of tetanus: epidemiological features, clinical profile and outcome from South India. Indian J Pediatr. 2016;83:1015-7. |
8 patients |
Range: 2–11 years |
Right foot laceration, left finger |
Lock jaw, difficulty in walking |
Unvaccinated: 6 Vaccinated: 2 |
Tetanus toxoid, crystalline penicillin, wound management care, HTIG |
Survived (n= 5) Died (n= 3) |