Tetanus laporan kasus
DOI: https://doi.org/10.56922/quilt.v6i5.2970
Clostridium Tetani Spasme Otot Tetanus Generalisata Trismus
Abstract
Background: Tetanus is an acute infectious disease caused by Clostridium tetani, which produces the neurotoxin tetanospasmin and causes muscle spasms and rigidity. Although preventable by immunization, tetanus is still found in developing countries.
Purpose: To describe the clinical manifestations and management of generalized tetanus.
Case: We report a 54-year-old man who complained of generalized stiffness since two days before hospitalization, accompanied by trismus and dysphagia. The patient had a history of a hand injury two weeks prior. Physical examination revealed risus sardonicus, trismus, and generalized muscle rigidity. The diagnosis was made based on the clinical presentation. The patient received human tetanus immunoglobulin, metronidazole, diazepam, and supportive therapy.
Conclusion: Early diagnosis and appropriate management are crucial to prevent complications and improve the patient's prognosis.
Keywords: Clostridium Tetani; Generalized Tetanus; Muscle Spasm; Trismus.
Pendahuluan: Tetanus merupakan penyakit infeksi akut yang disebabkan oleh Clostridium tetani yang menghasilkan neurotoksin tetanospasmin dan menyebabkan spasme serta rigiditas otot. Meskipun dapat dicegah dengan imunisasi, tetanus masih ditemukan di negara berkembang.
Tujuan: Untuk menggambarkan manifestasi klinis dan penatalaksanaan tetanus generalisata.
Kasus: Dilaporkan seorang laki-laki usia 54 tahun dengan keluhan kaku seluruh tubuh sejak dua hari sebelum masuk rumah sakit disertai trismus dan disfagia. Pasien memiliki riwayat luka pada tangan dua minggu sebelumnya. Pemeriksaan fisik menunjukkan risus sardonicus, trismus, dan rigiditas otot generalisata. Diagnosis ditegakkan berdasarkan gambaran klinis. Pasien mendapatkan terapi human tetanus immunoglobulin, metronidazol, diazepam, serta terapi suportif.
Simpulan: Penegakan diagnosis secara dini dan penatalaksanaan yang tepat sangat penting untuk mencegah komplikasi dan meningkatkan prognosis pasien.
Kata Kunci: Clostridium Tetani; Spasme Otot; Tetanus Generalisata; Trismus.
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References
Ahmadsyah, I., & Salim, A. (1985). Treatment of tetanus: an open study to compare the efficacy of procaine penicillin and metronidazole. Br Med J (Clin Res Ed), 291(6496), 648-650.
Bleck T., P. (2005). Clostridium tetani (Tetanus). In: Mandell GL, Bennett JE, Dolin R, editors. Principles and practice of infectious diseases 6th. Amsterdam: Elsevier Saunders; p. 2817–22. 2
Blencowe, H., Lawn, J., Vandelaer, J., Roper, M., & Cousens, S. (2010). Tetanus toxoid immunization to reduce mortality from neonatal tetanus. International journal of epidemiology, 39(suppl_1), i102-i109.
Center for Disease Control and Prevention. (2020). Tetanus. Epidemiology and prevention of vaccine-preventable disease 13th ed. p. 341- 51. Diakses dari: http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/tetanus.pdf
Cook, T. M., Protheroe, R. T., & Handel, J. M. (2001). Tetanus: a review of the literature. British journal of anaesthesia, 87(3), 477-487.
Duong, H. T. H., Tadesse, G. A., Nhat, P. T. H., Van Hao, N., Prince, J., Duong, T. D., & Thwaites, L. (2019). Heart rate variability as an indicator of autonomic nervous system disturbance in tetanus. The American journal of tropical medicine and hygiene, 102(2), 403.
Farrar, J. J., Yen, L. M., & Cook, T. (2000). Tetanus. Journal of Neurology, Neurosurgery & Psychiatry, 69, 292–301.
Fields, B., Guerin, C. S., & Justice, S. B. (2021). Don't be a stiff: a review article on the Management of Tetanus. Advanced Emergency Nursing Journal, 43(1), 10-20.
Fink, M. P., & Mitchell, P. (2005). Textbook of critical care. Philadelphia: Elsevier Saunders,.
Hassel, B. (2013). Tetanus: pathophysiology, treatment, and the possibility of using botulinum toxin against tetanus-induced rigidity and spasms. Toxins, 5(1), 73-83.
Hughes, M. M., Amin, A. B., & Rubis, A. B. (2026). Tetanus Surveillance—United States, 2009–2023. MMWR. Surveillance Summaries, 75.
Kementerian Kesehatan Republik Indonesia. (2013). Pedoman imunisasi. Diakses dari: https://ayosehat.kemkes.go.id/buku-panduan-pekan-imunisasi-dunia-2024-format-pdf
Kyu, H. H., Mumford, J. E., Stanaway, J. D., Barber, R. M., Hancock, J. R., Vos, T., & Naghavi, M. (2017). Mortality from tetanus between 1990 and 2015: findings from the global burden of disease study 2015. BMC Public Health, 17(1), 179.
Laksmi, N. K. S. (2014). Penatalaksanaan tetanus. Cermin Dunia Kedokteran, 41(11), 399128.
Sehiavo, G., Matteoli, M., & Monteeueeo, C. (2000). Neurotoxins affecting neuroexoeytosis. Physiol Rev, 80(2), 717.
Rossetto, O., & Montecucco, C. (2019). Tables of toxicity of botulinum and tetanus neurotoxins. Toxins, 11(12), 686.
Taylor A., M. (2006). Tetanus. Continuing education in anesthesia, critical care & pain, Vol.6 No.3.
Thwaites, C. L., Yen, L. M., Glover, C., Tuan, P. Q., Nga, N. T. N., Parry, J., & Farrar, J. J. (2006). Predicting the clinical outcome of tetanus: the tetanus severity score. Tropical Medicine & International Health, 11(3), 279-287.
World Health Organization. (2010). Current recommendations for treatment of tetanus during humanitarian emergencies. Diakses dari: http://www.who.int/iris/handle/10665/70219
World Health Organization. (2019). Tetanus vaccines: WHO position paper. Diakses dari: https://www.who.int/publications/i/item/WHO-WER9206
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