Abstract
Tetanus has become rare even exceptional in the West. On the contrary, it is common in developing countries such as Congo because of low immunization coverage. Its diagnosis, which is essentially clinical, is easy but necessitates a fine semeiological analysis under certain circumstances. We are reporting here a case of tetanus involving an 8-year-old unvaccinated, indigenous aboriginal boy that was caused by the extraction of a Tunga penetrans. The symptomatology of abdominal contractures led to an exploratory laparotomy. The evolution was favorable.
Highlights
Open AccessTetanus is a poisoning-severe acute infection caused by a neurotoxin produced by a gram positive bacillus Clostridium tetani or bacillus Nicolaier [1]
Tunga penetrans was extracted from several toes and reported diffuse abdominal pain in the form of cramps followed 24 hours later by spontaneous generalized spasms induced by stimuli
Tetanus is often found in children of low socio-economic parents living in densely populated sandy areas in precarious conditions [6] [7] [8] [9] [10] [12] [13]. This was the case of our patient as well as that reported by Ribéreau-Gayon [12] in the Democratic Republic of Congo, where indigenous peoples often live in forests, outside the education and health system, traveling long distances barefooted daily
Summary
Tetanus is a poisoning-severe acute infection caused by a neurotoxin produced by a gram positive bacillus Clostridium tetani or bacillus Nicolaier [1]. It has rarely become uncommon in the West due to, among other things, improved hygiene, higher socioeconomic status and widespread vaccination [1] [2]. In Congo, the rate of tetanus vaccination coverage, provided by the expanded immunization program, amounted to 72% for infants aged 12 to 23 months [4]. Tetanus vaccination for pregnant women is systematic. Beyond this age and apart from this physiological state, primary immunization and boosters are on individuals’ initiative and dependent on them. We are reporting a case of tetanus occurring in an eight-year-old child from an indigenous population whose symptoms of abdominal contractures led to an exploratory laparotomy
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