Severe Tetanus In Elderly With Minor Wound: A Case Report

Abstract

Tetanus is a serious infection caused by Clostridium tetani, and it poses a greater risk to the elderly due to factors such as weakened immune systems, underlying health conditions, and incomplete immunization status. While tetanus typically develops from contaminated or severe wounds, in older adults, even minor injuries such as a fish spine puncture can progress to severe generalized tetanus due to delayed inflammatory responses and subtle early symptoms. The aim of this study is to present a case of severe tetanus in an elderly patient resulting from a minor wound and to highlight the importance of early recognition, appropriate immunization, and prompt treatment to prevent fatal outcomes. This study employed a case report method to detail the clinical course of a 79-year-old man who developed severe generalized tetanus following a minor fish spine puncture. It highlights how underlying comorbidities and lack of prior immunization contributed to rapid disease progression and complications requiring intensive care. The report underscores the importance of early diagnosis, preventive vaccination, and aggressive management in elderly patients with even minor wounds. The results of this case report highlight that tetanus in elderly patients tends to be more severe and has a poorer prognosis due to factors such as immunosenescence, multiple comorbidities, and inadequate immunization history. In the reported case, a minor wound led to rapid clinical deterioration, including respiratory failure and cardiac arrest, exacerbated by underlying conditions like diabetes and hypertension. Delayed recognition of early symptoms and late medical intervention further worsened the outcome. This underscores the urgent need for proactive prevention through routine tetanus vaccination, timely administration of HTIG, early antibiotic therapy, and comprehensive management strategies, including mechanical ventilation and multidisciplinary care, to improve survival and quality of life in elderly tetanus patients.