Otogenic Tetanus Among Children In Ibadan, Nigeria

BackgroundTetanus is an acute disease of the nervous system caused by exotoxins of Clostridium tetani. Tetanus occurs when a wound is contaminated by the bacterial spores of the bacteria. A discharging ear could be contaminated by the spores. The paucity of publications especially in tropical Africa stimulated this work. AimTo evaluate otogenic tetanus among paediatric age group at University College Hospital, Ibadan, Nigeria. Method A 5 year retrospective study of patients with otogenic tetanus was carried out using the departmental registers and case files. ResultsTwenty five patients with otogenic tetanus were seen. There were 22 males (88%) and 3 females (12%) with M: F of 7:1 and an average age of 5.5yrs. The duration of illness prior to presentation ranged from 1 – 4 days while the period of hospitalisation ranged from 11 – 32days. The clinical presentations were otorrhoea (100%), trismus (100%) and intermittent spasm (90%). Right ear discharge was found in 60%, left ear discharge in 20% while bilateral ear discharge constituted 20%. Eight four (84%) received partial immunization while 16% never had immunization. Treatment was a combination of adequate aural toileting, use of antibiotics, sedatives, tetanus toxoid and antitetanus serum. Mortality rate was 4% ConclusionOtitis media predisposes to otogenic tetanus especially among paediatric age group. Hence, a thorough ear examination should be done in a child with tetanus without obvious wound.