- a certain degree of cervical stiffness
- difficulty in the motility of the upper left limb.
- her abdomen was widely painful and not very treatable.
- her blood pressure was 155/80mmHg
- her body temperature was 37.8 degrees C.
- intramuscular therapy with specified Human Antitetanic Immunoglobulins (500 U.I. im)·
- 4 gr Ampicillin + 2 gr of Sulbalctam (3 times a day) ·
- Metronidazole 500 mg 1 fl (4 times a day)
Table 1 - Annual rate* of tetanus cases and tetanus deaths - National Notifiable Diseases Surveillance System, United States, 1947--2008
In Italy, 56 cases of tetanus were reported in 2004, 49 cases in 2005, 64 cases in 2006, 62 cases in 2009, and mostly they were elderly people, as in the United States (4).
Instead the notifications reported from 2010 to 2014 were 255, corresponding to an average annual rate of 0.09 cases per 100 thousand inhabitants. The trend in notification rates indicates a reduction in the incidence that in 2014 stood at 0.06 per 100 thousand in habitants.
- culture examination of the wound tissue frustules
- biological test.
- Hospitalization in the Intensive Care Unit
- Support vital functions (BLS) if necessary: control and maintenance of airway patency, ventilation and circulation.
- Assess the state of consciousness (pupillary response, osteotendine reflexes, verbal and/or motor response) using the "Glasgow Coma Score"
- Passive immunization: human antitetanic immunoglobulins: 500 U.I. im
- Antibiotic therapy.
- Treatment of paroxysmal access involves the administration of benzodiazepines which, due to their GABA-ergic action, antagonize the action of tetanus toxin:
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