Abstract
The patient was a 54-year-old woman who had received injuries to the right forearm and elbow on December 25, 1987. She sought treatment at a hospital and the wound was disinfected and sutured. The patient became unable to open her mouth, suffered convulsions of the trunk and developed neck stiffness on January 1, 1988. She was admitted to the same hospital and diagnosed as having tetanus on January 4. The patient was so incapacitated that she had to be transported to our hospital and admitted to the ICU on January 5. After muscle relaxants had been administered, nasal intubation was performed. The patient's renal function gradually, deteriorated and we decided to treat her by hemodialysis. We were unable to continue this treatment because of a sudden hypotensive state due to sympathetic hyperactivity, so we treated her by peritoneal dialysis using an automatic peritoneal dialysis cycler (APD cycler) beginning on January 15. No problems or major complications were observed during the procedure. The patient's renal function recovered completely, and we discontinued peritoneal dialysis on February 23. The patient was discharged from our hospital on August 10 and returned to work with no sequelae. We briefly discussed the effect of peritoneal dialysis using the APD cycler and emphasized the usefulness of this treatment in such sympathetic hyperactive states of tetanus.
