Severe tetanus following ulcerated skin cancer Case report

Wang, Jin1,2; Yang, Ying3; Yang, Chao1,2; Lv, Wen1,2; Xu, Shihai1,2; Shi, Fei1,2; Shan, Aijun1,2

2020-07-31

10.1097/MD.0000000000021529

MEDICINE   影响因子和分区

0025-7974

1536-5964

Rationale: Tetanus is usually caused by wound infection withClostridium tetaniafter acute injuries. Skin cancer wound is a rarely reported cause oftetaniinfection. It is difficult to be diagnosed and mistaken for other brain lesions. Patient concerns: A 49-year-old man presenting with the only symptom of repeated convulsions was admitted to our department. He had an ulcerated skin cancer on the right buttock that had been excised in another hospital 1 month before admission, leaving the wound unhealed. He was suspected of having a metastatic brain tumor early, but exhibited a negative cranial CT-scan. Diagnosis: Tetanus was diagnosed when he was observed to have sudden convulsions after sensory stimulation such as noise, light, or touch. Interventions: Despite administration of a high dose of diazepam and phenobarbitone, continuous generalized rigidity with laryngospasm still occurred. Instead, when propofol was intravenously infused, the spastic convulsion completely stopped. Tracheotomy and mechanical ventilation were performed. Outcomes: The patient gradually recovered in 2 weeks. Lessons: Tetanus is rarely infected through the wound of an ulcerated skin cancer. Early diagnosis can only be based on accurate assessment of clinical manifestations, and propofol infusion appears to be more effective in anti-convulsion management for patients with tetanus. Routine vaccination to prevent tetanus in patients with ulcerated skin cancer should be considered in the future clinical work.

tetanus cancer propofol case report

SCI

英语

通讯

Medical Scientific Research Foundation of Shenzhen Health Commission[szfz2018022] ; Science and Technology Innovation Foundation of Shenzhen[JCYJ20160422152608675][JCYJ20190806150005453]

General & Internal Medicine

Medicine, General & Internal

WOS:000562693800130

LIPPINCOTT WILLIAMS & WILKINS

CLINICAL MEDICINE

Web of Science

1.Jinan Univ, Clin Med Coll 2, Shenzhen Peoples Hosp, Dept Emergency, Shenzhen 518020, Peoples R China
2.Southern Univ Sci & Technol, Affiliated Hosp 1, Shenzhen 518020, Peoples R China
3.Futian Women & Children Hlth Inst, Dept Pediat, Shenzhen, Peoples R China

Wang, Jin,Yang, Ying,Yang, Chao,et al. Severe tetanus following ulcerated skin cancer Case report[J]. MEDICINE,2020,99(31).

Wang, Jin.,Yang, Ying.,Yang, Chao.,Lv, Wen.,Xu, Shihai.,...&Shan, Aijun.(2020).Severe tetanus following ulcerated skin cancer Case report.MEDICINE,99(31).

Wang, Jin,et al."Severe tetanus following ulcerated skin cancer Case report".MEDICINE 99.31(2020).