Frequency of Acute Kidney Injury in tetanus patients of Paedriatic Intensive Care Unit: A Public Hospital Experience

Rhabdomyolysis with acute anuria renal failure caused by surgical injection-induced tetanus in an adult

Tetanus is a rapidly progressive infection characterised by painful spasms and muscular rigidity with a series of complications including airway obstruction, respiratory failure, pulmonary infection, heart arrhythmias and acute kidney injury. Rhabdomyolysis with acute anuria renal failure is rarely reported as a complication in tetanus. We present a case of an adult who suffered from rhabdomyolysis combined with acute anuria renal failure caused by surgical injection-induced tetanus. This patient was treated with tetanus immunoglobulin, control of muscle spasm, mechanical ventilation and haemoperfusion plus continuous veno-venous haemofiltration (CVVH). The patient fully recovered and was discharged from hospital 5 weeks after admission. Good bowel preparation is an important prerequisite for preventing tetanus in a haemorrhoids operation. Effective control of muscle spasms with neuromuscular blockers and early administration of haemoperfusion plus CVVH are vital to the treatment of tetanus-induced rhabdomyolysis with acute renal failure.

Clinical features and outcomes of tetanus: a retrospective study

Background: Tetanus is a serious disease resulting in muscle spasm, and even death. Methods: A retrospective, single-center study was conducted by analyzing demographic and clinical parameters. Results: The study included 12 males (70.6%) and 5 females (29.4%). The mean age of the patients was 56.71±9.05 years. Patient occupations included farming (47.0%), retired (23.5), homebound (23.5), and workers (6.0%). The causes of patient injuries were as follows: metal injury (52.9%), deep injury (29.4%), electrical injury (5.9%), maxillofacial region and knee injury (5.9%), and skin ulceration (5.9%). The disease duration ranged from 3 to 36 days, and the mean incubation period was 12.65±10.17 days. Four patients had co-morbidities. The infected patients were given tetanus antitoxin (TAT) and antibiotics treatment. One patient was given continuous renal replacement therapy (CRRT) and only one patient died. Conclusions: In our department, although tetanus is a serious disease, with effective treatment, patients have reasonable cure and low death rates.