A case of puerperal tetanus with recovery

Obstetric tetanus in an immunized patient

Obstetric tetanus is defined as a C. tetani infection that occurs during pregnancy or within six weeks of delivery. In Peru, there are no reports of obstetric tetanus cases. Here we report a sixth case of obstetric tetanus in a puerperal woman who underwent curettage for postpartum hemorrhage, despite immunization against tetanus.

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Obstetric tetanus is exceedingly rare, with only five cases reported worldwide.

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Complete tetanus vaccination should not exclude tetanus as a working diagnosis.

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The source of C. tetani infection may be unknown.

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Tetanus classically presents with rigidity and painful muscle spasms.

Puerperal infection in the antibiotic era

Developments in etiology and treatment of puerperal infection in the last 20 years are reviewed. Emphasis is placed upon predisposing factors, microbiology and antibiotics, unusual sources of severe infection, special complications, and prophylactic antibiotics.

Tetanus: principles of management and review of 37 cases

Thirty-seven patients were treated for tetanus. Of these, 24 required neuromuscular blockade and intermittent positive pressure ventilation; the remaining 13 were managed chiefly with diazepam. Of the eight deaths in the series, three were the direct or indirect result of gastrointestinal complications. A management regime for tetanus is outlined and the complications that were encountered are discussed.