Tetanus; experience and current approach of treatment in a general hospital

Objective: Report of a series of cases of tetanus and learned experience in the diagnosis and treatment of this disease, which continues to prevail in developing countries such as ours. Methods: This is a descriptive and retrospective study of a series of cases of tetanus diagnosed in Acapulco General Hospital from January 2015 to January 2019. Results: A total of 6 cases of tetanus were reported in adults who had not been vaccinated or had not received an adequate tetanus vaccination. All patients were isolated in a silent, dark room in Intensive Care Unit (ICU). Five patients needed a tracheotomy and respiratory support. 4 of them underwent early tracheotomy as a management protocol of the hospital. All patients received tetanus toxoid and immunoglobulin on admission. Two deaths occurred throughout the period of the study. Conclusions: These cases highlight the difficulties of early diagnosing and adequately managing rare diseases such as tetanus in health care systems of developing countries such as Mexico, being this a highly preventable infectious disease by vaccination. Our hospital is characterized by a low mortality rate in patients with tetanus due to our systematized and multidisciplinary clinical experience.