Clinical Profile of Otogenic Tetanus in an Infectious Disease Hospital, Kolkata
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2019, Vol 18, Issue 1
Abstract
Introduction: Tetanus is a preventable disease caused by Clostridium tetani. Tetanospasmin, an exotoxin is responsible for it’s clinical manifestation. In developing countries like India it has great importance. Otogenic tetanus is mainly due to poor hygiene, lack of knowledge in health education and tetanus prophylaxis. Materials & Methods: During the year 2011 to 2017 total number of 523 tetanus cases were admitted at Infectious Disease & BG (ID&BG) Hospital, Kolkata and otogenic cases were studied from ward and case sheets. Results: Among total 523 cases otogenic tetanus cases were 61 (11.66%). Male Female ratio was 1:1. Duration of otogenic symptoms prior to presentation was 10 days to 1 year. Incubation period was not properly judged and average onset time 8 hours in death cases and 36 hours in survived cases. In survived cases 75.40% were below poverty level. According to Ablett grading system otogenic tetanus cases were found in Grade 1 =15(24.59%), Grade 2= 25(40.48%), Grade 3=9(14.75%), Grade 4= 12(19.67%). Otogenic findings were—otorrhoea 53(86.88%), chronic suppurative otitis media (CSOM) 23(37.70%), acute otitis 38(62.29%). Right ear discharge was more common. Out of 61 cases only 9(14.75%) were immunized completely, 44(72.13%) were immunized partially, 8(13.11%) were never immunized. Mortality was 19.67%(n=9) among otogenic tetanus cases. Pond bathing (n=38, 62.29%) and ear pricking (n=23, 37.70%) were the major precipitating factors. Conclusion: If no wound found in tetanus cases, proper ear examination to be done, particularly in children. Proper immunization and care of ear is important.
Authors and Affiliations
Dr Uttam Kumar Pandit, Dr Arijit Sinha
Keywords
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