ObjectivesTetanus is a potentially lethal infection and remains a priority public health problem in countries with low vaccination coverage. We aim to synthesize the evidence on the clinical-epidemiologic characteristics of oral (odontogenic) tetanus.MethodsWe report a case of oral tetanus. Furthermore, we collected eligible articles about oral tetanus published to date. We performed a systematic review with an exhaustive search of the literature published up to June 30, 2022, in Medline (PubMed), Google Scholar, Scopus, EMBASE, Web of Science, and ScienceDirect.ResultsWe analyzed 19 studies that enrolled 26 cases of oral tetanus. The mean age was 51.60 ± 21.95 (range 10-77) years. The frequency and lethality of odontogenic tetanus were higher in males than females. More than 60% of cases occurred in North America. Almost three-quarters of cases were associated with a dental procedure - mainly dental extraction - meanwhile, tooth decay accounted for 23% of cases. The median incubation period was 8.0 (IQR 10.0) days. The time between trismus and death was 4.25±1.89 (range 3-7) days. Clostridium tetani was isolated in only 11.54% of cases. Administration of anti-tetanus immunoglobulin alone or combined with anti-tetanus toxoid was reported in at least 42% of cases, and antibiotics in 32% of cases. Patients required tracheostomy and mechanical ventilation in 12% and 8% of cases, respectively. The mean hospital stay was 18.38±14.97 (range 4-53) days. The lethality of odontogenic tetanus was (30.77%).ConclusionSince the diagnosis of tetanus is merely clinical, it is crucial to have a high index of suspicion to diagnose this disease correctly. Although odontogenic tetanus is rare, it is potentially life-threatening.

01 Sep 2022·Oxford Medical Case Reports

Successful management of generalized tetanus in a 12-year old girl without anti-tetanus immunoglobulins: a case report

Author: Zita, Ahivaldino ; Naber, Yasmin Al ; Seni, Amir ; Arzuaga, Danys Alvarez ; Pizzol, Damiano ; Muhelo, Arlindo ; Smith, Lee

ABSTRACTIn low-income countries tetanus is a major public health concern owing to a low immunization coverage and unclean birth practices. Although it is a vaccine-preventable disease, tetanus can be contracted across the life course. The disease is prevalent and harmful in newborn babies and their mothers when the mothers` are unvaccinated against tetanus. We report on a case of a 12-year-old girl who presented with general malaise, anorexia, dysphagia, trismus and dehydration, which rapidly developed into severe generalized tetanus and was successfully managed in a low-resource setting without the availability of human anti-tetanus immunoglobulins.

01 Jan 2018·Iranian journal of pharmaceutical research : IJPRQ4 · MEDICINE

Initial Results of a Prospective Study and Identification of New Strategies to Increase Traceability of Plasma-derived Medicines.

Q4 · MEDICINE

Article

Author: Sheyda Najafi ; Hedieh Keshavarz-Bahaghighat ; Ali Vasheghani Farahani

Plasma medicine is an innovative and emerging field used in a broad range of medical conditions. The present study focused on consumption and documentation pattern of plasma-derived medicines in a teaching hospital. A two-step study was conducted from October to December 2015. During the first phase, the patient records receiving plasma-derived medicines including Coagulation Factor VIII, IX, Prothrombin Complex Concentrate, Factor VIII/Von Wilberand Complex, Anti-Hepatitis B Immunoglobulin, Intravenous Immunoglobulin, Anti-Tetanus Immunoglobulin, and Albumin were checked to assess recording details of these medications at the time of administration. Adverse events reported with the mentioned products were examined from traceability viewpoint. The second step concentrated on practical strategies to improve documentation status of plasma-derived medicines in the hospital. We proposed national guideline as the first strategy and a new barcoding system to track and identify drug information of plasma medicines. Of the expected drug information, only generic name, dosage from, and strength were recorded after administration. Post-marketing safety surveillance of the plasma products was poor similarly. Unavailability of suitable instructions was the main reason for documentation deficiency. A guideline was designed and implemented to inform healthcare professionals about essentials of appropriate documentation for plasma-derived medicines. Updated results of the ongoing phase will be submitted soon. Our survey highlights the importance of documentation as a key component of plasma-derived medicines surveillance within the hospitals.

100 Deals associated with Human Anti-Tetanus Immunoglobulin (Xinjiang Deyuan)

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Indication	Country/Location	Organization	Date
Tetanus	CN	Xinjiang Deyuan Biology Engineering Co. Ltd.	29 Jan 2023

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