Tetanus: a recurring intensive care problem

ABSTRACT

A fifteen-year retrospective study of 108 cases of tetanus admitted to the Intensive Care Unit (ICU) at the University Hospital of the West Indies is presented. Males predominated (70 percent), with peak incidence occurring amongst the young and the elderly. In 57 percent the disease was severe enough to require neuromuscular blockade and controlled ventilation. Respiratory complications occurred most commonly (80 percent), predominantly as a result of infection. Dysautonomia, exhibited by 55 percent of patients, presented the greatest difficulty in management. Mortality was high (20 percent), with sudden cardiac arrest being the most common cause of death. The average duration of stay in the ICU was long (27 days). As Jamaica is a Third World country with limited resources, the continued occurrence of this preventable disease represents a drain on existing intensive care funds. This must be brought to the attention of institutions responsible for planning health care programmes for developing countries (AU)