SEVERE TETANUS IN INTENSIVE CARE UNIT: ABOUT 20 CASES

Introduction: Tetanus is a non-contagious, not immunizing, infectious disease. In developed nations, effective immunization programs have led to a significant decrease in its incidence, making it a rare pathology only seen sporadically. In Morocco, the disease remains a major health problem leading to multiple deaths every year. Materials and Methods: This is a five-year period retrospective study, including all cases of severe tetanus hospitalized in the two intensive care units (ICU); A1 and A4, at the Hassan IId teaching hospital. Results: Twenty cases were included in this study. The mean age of our sample was 50 years old. The sex ratio was 5.6 M / F. None of our patients had undergone a proper vaccination. 90% of our patients presented paroxysms when first admitted to the ICU. All had a lockjaw. 13 patients were intubated. Twelve patients received injectable midazolam. Five patients required continuous curarisation. All patients received serum therapy and 16 of whom were put on metronidazole. Eleven patients died. Discussion and conclusion Tetanus still prevails in third-world countries. In Morocco, the disease targets young males as opposed to developed countries. Generalized tetanus treatment is complex and requires hospitalization in intensive care and close monitoring of the patient. Its mortality is still high. Mortality risk factors in our study included: advanced age, high dosage of CRP, wound depth, kidney failure, neuro-vegetative disorders and sepsis.