Recurrent tetanus in diagnosed breast cancer patients of the Philippine General Hospital

Abstract

This is the first report of recurrent tetanus in two cases of breast cancer. The first case is of a 40-year old female with intraductal carcinoma of the right breast who was admitted for tetanus with breast mass ulcers as presumptive focus. She was given anti-/INS;tetanus vaccines and appropriate antibiotics. No wound debridement was done for fear of tumor seeding. She was discharged clinically cured of tetanus. Despite adequate treatment, the patient had recurrence of the tetanus 40 days after discharge. The second case is of a 56-year old female diagnosed with intraductal carcinoma of the left breast who developed tetanus after accidentally injuring the breast mass with a door nail. Similarly, she was given anti-/INS;tetanus vaccines and appropriate antibiotics. There was no consent to any intervention on the breast mass. She was discharged cured, but returned after 32 days with recurrent tetanus. The recurrence of tetanus in these patients could be due to incomplete elimination of the infection, presence of chronic wound, and inability to mount sufficient immunity. Tetanus is a preventable and treatable condition with high mortality. Gathering of local data on recurrent tetanus and vaccine efficacy may be subject of future studies. It is recommended that guidelines on the management of tetanus specifically in immunocompromised patients with untreated chronic wounds as well as policies on routine vaccination of cancer patients be formed.