A CASE OF SEVERE TETANUS

A 58-year-old man, who got hurt at work, developed tetanus after latent period of 10 days with the onset time of 4.5 days. On the 5th hospital day, tracheostomy was performed and the patient was managed by mechanical respiration. Sympathetic overactivity which occurred on the 10th hospital day accompanied by tachycardia up to 200 times a minute, and the blood pressure remarkably varied. Systemic convulsion was also noted, for which pancronium bromide and diazepam were hardly effective. I.v. drip infusion of chlorpromazine and cooling of thewhole body with ice could stabilize the blood pressure, decrease heart rate, and alleviate the convulsion, when urinary catecholamines increased. On the 9th day the patient was diagnosed as disseminated intravascular coagulation (DIC) based on clinical symptoms and labolatory findings. Various treatments for DIC could yielded a cure. The patient was set free from the mechanical respiration on the 17th hospital day. On the 39th hospital day he was discharged without any sequelae.