Peer-reviewed article
Rare Survival of a 9-Year-Old Boy Managed for Post-Neonatal Tetanus Without Intensive Care at Soroti Regional Referral Hospital, Uganda: A Case Report.
Amos Odiit, Fridah Akello, Tadeo Lujuna, Joseph Katende Mukiibi, Charles E Engoru et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This case report describes the successful treatment of a 9-year-old boy with post-neonatal tetanus in Uganda who had never received tetanus vaccination. The child presented with severe symptoms three days after a minor foot injury and was managed on a general paediatric ward without intensive care facilities. With basic supportive care including wound care, antibiotics, sedation, and delayed administration of tetanus immunoglobulin, the child recovered after 25 days in hospital. The case demonstrates that post-neonatal tetanus can be survivable in low-resource settings with adequate supportive care.
Key points
- The child had never received tetanus vaccine during infancy or any boosters before injury
- Severe generalized tetanus (Grade 3) was successfully managed without access to intensive care services
- Treatment included wound care, antibiotics, nasogastric feeding, bladder catheterization, and sedation with diazepam and chlorpromazine
- Tetanus immunoglobulin was administered 10 days after hospital admission and may have improved outcomes
- The child was hospitalized for 25 days and discharged alive
Limitations
This is a single case report and cannot demonstrate whether the outcomes are generalizable or what factors were most critical to survival. The report does not provide comparative data on survival rates with and without the interventions used, or analysis of which specific treatments contributed most to recovery.
Abstract
BACKGROUND: Tetanus is a vaccine-preventable disease caused by neurotoxin from Clostridium tetani bacteria. Although neonatal tetanus has declined in many settings, post-neonatal tetanus continues to occur in low-resource countries where vaccination coverage and booster implementation remain suboptimal. Mortality in post-neonatal tetanus remains high, particularly where intensive care services are limited. CASE PRESENTATION: We report a 9-year-old African boy who presented three days after a minor toe injury with generalized painful muscular spasms, trismus, and hypertonia consistent with generalized tetanus (Ablett classification- Grade 3). He neither received the tetanus vaccine during infancy nor any boosters prior to this injury. He was managed on the general paediatric ward in a dark, quiet room without access to intensive care. He was hospitalized for 25 days and his treatment included wound care, antibiotics, nasogastric feeding, bladder catheterization, and alternating sedation with diazepam and chlorpromazine. Due to limited availability, human tetanus immunoglobulin was administered 10 days after hospital admission. The child recovered and was discharged alive. CONCLUSION: Post-neonatal tetanus can be successfully managed in low-resource settings with strong supportive care even in the absence of intensive care services. Human tetanus immunoglobulin may still improve outcomes even when administered several days after exposure.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Supportive care including wound care, antibiotics, nasogastric feeding, bladder catheterization, sedation with diazepam and chlorpromazine, and delayed tetanus immunoglobulin administration
- Population
- One 9-year-old African boy with generalized tetanus (Grade 3 severity)
Key finding
Child survived severe generalized tetanus without intensive care facilities
Odiit et al. · PubMed (US National Library of Medicine) · 15 Jun 2026