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May 1964

Recent Trends In Tetanus

Author Affiliations

National Heart Institute Clinical Training Fellow, US Public Health Service grant HTS5170-07 (Dr. Hewitt).; National Cancer Institute Clinical Training Fellow, US Public Health Service Grant CLT7087-Cl (Present address: Collon and Carney Clinic, Texarkana, Tex (Dr. Wren).; National Cancer Institute Research Career Awardee CA-K6-1087-02 (Dr. Krementz).

Arch Surg. 1964;88(5):768-773. doi:10.1001/archsurg.1964.01310230044010

Introduction  Tetanus, although less common today than in former years, remains a challenge to the medical profession. The case fatality rate for tetanus is generally regarded to approximate 50%, and the organism Clostridium tetani, an anaerobic, Gram-positive rod which forms spores, is universal in distribution, particularly in soil and feces. The case fatality rates observed in various studies of tetanus conducted at the Charity Hospital of Louisiana at New Orleans have declined since 1906 but still remain alarmingly high (Table 1). The present review of experiences at this same institution from 1957 through 1961 was undertaken to bring attention to continuing problems in diagnosis and treatment of this preventable infection. Of the 80 patients with tetanus seen at Charity Hospital during this five-year period, 65 had traumatic tetanus and 15 had tetanus neonatorum (Table 2). Their ages ranged from the newborn period to 84 years.

Prophylaxis.  —Tetanus rarely occurs in

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