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Title: EAR PIERCING: A GATEWAY TO TETANUS
Authors: Hassan Mumtaz, Nahdia Zaman, Anam Zafar, Tariq Saeed, Shahzaib Ahmad
Journal: Pakistan Armed Forces Medical Journal (PAFMJ)
Publisher: Army Medical College, Rawalpindi.
Country: Pakistan
Year: 2022
Volume: 72
Issue: 2
Language: English
DOI: 10.51253/pafmj.v72i2.7135
Keywords: Clostridium tetaniMuscle spasmsPreventive Medicineskin taggingNeuromuscular disease
Tetanus is initiated by the release of neurotoxins. The progressive paralysis of several muscles is due to contamination of the wound by the toxin. The case under discussion was about a patient with the tetanus infection after ear piercing due to unsterilized instruments and lack of awareness of complications. Due to the late presentation to the hospital, leading to a delay in treatment, the child could not survive. Physicians need to have a vigilant eye to have a high suspicion for tetanus at a very early stage and immediate initiation of advanced critical care, which can favour lifesaving interventions. Prophylactic tetanus toxoid should be administered before any body piercing
To highlight the risk of tetanus infection following ear piercing due to unsterilized instruments and lack of awareness, and to emphasize the importance of early diagnosis, critical care, and prophylactic tetanus toxoid administration.
Case report detailing the presentation and management of a six-year-old female child with tetanus infection following ear piercing. The report discusses the clinical course, treatment initiated according to WHO protocol, and outcomes, drawing upon existing literature and studies.
graph TD;
A["Patient presents with symptoms after ear piercing"] --> B["Assess symptoms and history"];
B --> C["Identify potential tetanus infection"];
C --> D["Initiate treatment: ventilation, sedation, antibiotics, tetanus toxoid, immunoglobulin"];
D --> E["Monitor patient's condition"];
E --> F["Evaluate outcome"];
F -- Survival --> G["Discharge and follow-up"];
F -- Non-survival --> H["Case report and discussion"];
H --> I["Recommendations for prevention and awareness"];
The discussion highlights that tetanus infections are rare in immunized individuals in Western countries but can still occur in non-immunized populations. It emphasizes the high morbidity and mortality rates, potential complications like pneumonia due to laryngospasm, and the lack of definitive laboratory diagnostic criteria. The importance of early diagnosis, advanced critical care, wound management, and public education on sterilization and vaccination is stressed.
A six-year-old girl developed tetanus after ear piercing with unsterilized instruments. Despite hospitalization and treatment, the child did not survive due to delayed presentation and treatment. The report underscores the diagnostic challenges and the need for increased awareness and vaccination.
Ear piercing with unsterilized instruments can be a gateway to tetanus, particularly in individuals with incomplete immunization. Early suspicion, prompt critical care, and prophylactic tetanus toxoid administration before body piercing are crucial for preventing severe outcomes and improving patient survival. Public education on the risks and preventive measures is essential.
1. Patient Age: The case report describes a six-year-old female girl. (Confirmed in Case Report section)
2. Cause of Infection: Tetanus infection was suspected after ear piercing due to unsterilized instruments. (Confirmed in Abstract and Case Report sections)
3. Outcome: The child could not survive due to late presentation and delay in treatment. (Confirmed in Abstract and Case Report sections)
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