耳鼻咽喉科を受診した破傷風の一症例

抄録

Tetanus, an infectious disease designated by law is a disease which has long been known. With a progress of chemotherapy and immunotherapy in recent years, the incidence of this disease decreased markedly particularly after the end of the World War II, with the highest incidence of 2168 cases in 1949. Once affected by this disease, however, the patient follows a very serious clinical course, and even today the mortality rate from this disease is still high.
This case is a 25-year-old man, a cook by profession.
On April 9, 1983, he underwent operation for phimosis.
On the 10 th postoperative day he had pharyngeal dysphoria, difficulty in swallowing and in opening the mouth.
Diagnosis of tetanus was made on the basis of clinical symptoms. Treatment using tetanus human immunoglobulin, antispastic agent and muscle relaxant was instituted immediately. Because of dyspnea resulting from general convulsion, tracheostomy was performed on May 2. The patient was able to survive without any sequelae.
Otorhinolaryngologists have few opportunities to encounter tetanus despite the fact that complaints peculiar to the area of otorhinolaryngology such as pharyngeal dysphoria, difficulty in swallowing and hardness of mouth-opening are very often heard of as Stage 1 and Stage 2 symptoms of tetanus.
Tetanus would not be eradicated, since vacillus tetani exists widely in soils and intestines.