An Ipswich man was recently discharged from St Andrew’s Ipswich Private Hospital, after contracting tetanus - a once common bacterial infection that is now considered rare in First World countries.
At the beginning of the Covid-19 pandemic, the 69-year-old man spent time on his brother’s farm and presented with symptoms of gastro-enteritis.
It was not until two weeks into the patient’s ICU treatment that intensive care specialists, Professor Jeffrey Lipman and Doctor Satnam Solanki, diagnosed the man with tetanus, after a process of elimination.
“Typical clinical presentation like lockjaw or severe muscle spasms is usually diagnostic,” Dr Satnam Solanki said.
As the patient had neither any visible wounds nor muscle spams for fourteen days, which is also the incubation period for tetanus, Dr Satnam Solanki said the absence of the typical symptoms led to a delay in diagnosis.
“A majority of clinicians have not seen tetanus in real life, which makes it difficult to diagnose.
“There are only few clinical conditions that could present like tetanus.
“We excluded all the other diagnoses to reach the conclusion.”
As the patient was put into an induced coma for five to six weeks and required a ventilator to breathe, Dr Satnam Solanki said it was necessary to heavily sedate and paralyse him with medications in order to prevent severe muscle spasm during his stay in ICU.
“He required invasive lines put inside his artery and heart to control his blood pressure and heart rate.
“He was treated with antibiotics for infections which is quite common in ICU patients who are ventilated for long periods of time.
“He developed severe deconditioning due to loss of muscle mass over six weeks.”
However, as soon as the patient began to show signs of improvement, Dr Satnam Solanki said he was taken off the ventilator and with help, he learned how to talk, swallow, eat, drink and walk again.
Only ten cases of the illness are reported in Australian hospitals each year with two thirds aged 65 and over.
Although it’s a rare illness, Dr Solanki urged everyone to keep up to date with immunisations.
“Get a tetanus shot especially if you are over 65 years of age and haven’t had a tetanus booster in last 10 years.
“Punctured and soil contaminated wounds are very high risk if immunization is not up to date.”