Otogenic tetanus in Zaire

Abstract

Sixty-seven patients with tetanus of otogenic origin were hospitalized at the Mama Yemo hospital, Kinshasa, Zaire over the two-year period from 1975 through 1976. The care of these patients was the same as that for all 620 tetanus cases admitted during this period. No otologic surgical procedures were performed on this group; nor were any special ear procedures utilized. The survival rate in the otogenic tetanus group was 83%. The survival rate in the 620 tetanus admissions was 79%. All 67 patients had evidence of chronic otitis media. None of these patients had evidence of otologic complications before, during or for one month after developing tetanus, other than uncomplicated otorrhea. Tetanus antitoxin of 10,000 or 50,000 IU did not appear to affect survival rates. Mortality rates were not increased in the 18% of patients who did not receive tetanus antitoxin. Sedation sufficient to eliminate muscle spasms and maintain the patient sleeping seems to be important in increasing survival rates in tetanus. The need for tracheotomies appeared to be reduced with the increased sedation. Mortality rates increased among the patients who had tracheotomies. Otologic surgical procedures do not appear to be indicated in the management of patients with otogenic tetanus.