メトロニダゾール点滴静注による治療が奏功した破傷風の1 例

抄録

Penicillin G has been generally used for the treatment of tetanus in Japan, while metronidazole is widely chosen in other countries. We report herein on the first case of tetanus successfully treated with metronidazole intravenous drip infusion in Japan. A 76-year-old Japanese man injured his left hallux 15 days before admission．Three days before admission, he noticed lock-jaw and then difficulty in opening his mouth and remarkable muscle rigidity developed. He was diagnosed as having tetanus. He was intubated and mechanical ventilation was initiated. Metronidazole and human anti-tetanus immuno globulin were administered intravenously. Tetanus toxoid was injected intramuscularly. Several kinds of anticonvulsants were also given. Debridement of the foot wound was performed. He recovered without any sequelae. Metronidazole intravenous infusion became available in Japan in September, 2014 and could be considered as a therapeutic option in patients with tetanus in Japan.