News published by El Faro de Vigo
- These acute infections have plummeted with immunization, and only four patients were reported across Spain in 2023.
- It is a life-threatening medical emergency that requires early diagnosis and specialized resources.
Tetanus is not eradicated and cannot be eradicated, because the spores of the Clostridium bacteria that cause it are everywhere—especially in soil, ash, intestines, and feces. However, Vaccination has drastically reduced cases of this serious infectious disease of the nervous system in Spain. The number of cases dropped from 90 in 1983 to just four in 2023—the last year with official figures from the Ministry of Health. In fact, in the last four years with available data, only two cases were reported in all of Galicia, despite it being one of the regions with the highest incidence. So, "Most doctors have never seen one and never will," Neurologist Santiago Trillo maintains that it is crucial to diagnose and treat it promptly because, as internist María Alonso warns, "it remains a medical emergency requiring a high index of suspicion and with a significant mortality rate even in developed countries."
At the hospital where they work, in Ribera Povisa, They successfully solved one at the end of October last yearHe was an 80-year-old man who went to the emergency room with altered mental status, slowed attention and speech, pain, and fever. He was admitted to treat what was suspected to be a urinary tract infection.
But the next morning, on the ward, they find that his condition has worsened, with generalized rigidity and muscle spasms in response to minor stimuli"It wasn't showing the most obvious signs of the disease," explains Dr. Alonso. She thought it might be tetany, a neuromuscular syndrome caused by low calcium levels, but the tests came back normal. "Could it be tetanus?" she wondered.
Diagnosis
She consulted with another colleague in her department and with Dr. Trillo, who has experience in assessing acute neurological diseases. "I'd never seen anything like it. Its manifestations are very dramatic, due to the progressive rigidity of the muscles," she explains, adding that "It can be very distressing for the patient because the body becomes rigid, The arms and legs are affected; there is a marked extension of the neck and a contraction of the jaw that makes it difficult to speak. but at all times he is aware of what is happening." He even went so far as to perform an opisthotonus, an extreme arching of the back backward, supporting himself only on his head and heels.
They performed an urgent brain CT scan and lumbar puncture, which revealed no abnormalities. The family told them they had visited a podiatrist the previous day because a wound he had sustained on his foot on the farm that he cultivates.
"If the clinical suspicion is very high, you have to start treatment and send the patient to the ICU, even if the patient is stable, because It is a life-threatening medical emergency, can progress very quickly"He was very rigid and had respiratory failure," explains Dr. Alonso. In fact, shortly after being transferred, they had to intubate him. They neutralized the effect of the toxin with anti-etatin gamma globulin, prevented more from being created by attacking the bacteria with antibiotics, and cleaned the wound.
Result
"Since we suspected it quite quickly, treatment was started very quickly and he made a full recovery within a few days," The professionals emphasize that, even with adequate care, the mortality rate ranges between 10 and 50% of cases. In the last four decades with available data—from 1983 to 2022—it has killed 439 people in Spain, although only 14 in the last decade.
Newsletter: 
