• Alexandre Pérez-González, Isabel Fernández-Castro, Alejandro Araújo-Ameijeiras, Judith Álvarez-Otero, Antonio Ocampo, and Javier de la Fuente.
• Group of Virology and Pathogenesis, Galicia Sur Health Research Institute, Vigo, Spain; Internal Medicine Department, Alvaro Cunqueiro Hospital, Vigo, Spain. Electronic address: alexandre.perez@iisgaliciasur.es.
• Med Clin (Barc). 2022 Aug 12; 159 (3): 147-151.

BackgroundTetanus disease is caused by Clostridium tetani, an anaerobe bacteria found in dust and soil. Once reached human body through damaged tissues, C. tetani releases several neurotoxins which block the inhibitory function, leading to an increased muscle tone, ultimately causing respiratory failure. Severe tetanus is a life-threatening disease, especially in low-income-regions.MethodsThis is a retrospective case-series study, undertaken at two hospitals of Vigo (population area 600,000 inhabitants). Tetanus cases were identified through the discharge databases of both hospitals between the years 1995-2019. Epidemiological and clinical data were obtained from the patient's medical records.ResultsA total of 33 cases were identified; median age was 67 years, and most of patients were women (n=16, 55.2%). Generalized tetanus was the most common clinical course, and neck stiffness was the most frequent symptom. A total of 25 patients (86%) were admitted to the Intensive Care Unit, 21 required invasive ventilation and 2 patients died.DiscussionThe incidence of tetanus was low but most of cases were severe. Mortality was slightly higher than previously reported. Interestingly, the deceased patients were old-women, consistent with previously reported research in high-income-regions, while mortality in low-income-countries concentrates in middle-aged men.Copyright © 2022 Elsevier España, S.L.U. All rights reserved.

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