Tetanus merupakan infeksi oleh C.tetani yang menjadi masalah kesehatan penting di negara-negara berkembang. Perjalanan penyakitnya biasanya lama, memerlukan waktu berminggu-minggu atau berbulan-bulan untuk perawatan hingga sembuh. Beberapa penelitian telah dilakukan untuk menentukan berbagai faktor yang berpengaruh terhadap prognosis tetanus. Faktor tersebut adalah derajat spasme, usia, sedasi dan takikardia yang berpengaruh signifikan terhadap mortalitas pasien tetanus. Bila pasien tetanus dapat melewati fase akut penyakitnya, masalah lain timbul seperti disfungsi otonom dan pneumonia nosokomial (sering disebabkan oleh organisme multiresisten) sebagai penyebab tersering kematian. Laporan kasus berikut menampilkan 6 kasus tetanus, tiga di antaranya mengalami pneumonia nosokomial, dan dua di antara tiga pasien tersebut geriatri berusia 70 dan 72 tahun meninggal saat di rumah sakit. (Med J Indones 2004; 14: 117-21)
Tetanus, an infection by C.tetani continues to be a major health problem in the developing world. The course of the disease is typically prolonged, requiring weeks to months of supportive management to resolve. Several studies have been conducted to determine which factor/s really influenced the outcome of tetanus. Factors such as severity of spasms, age, sedation and tachycardia were found to significantly influence mortality. Patients now surviving the initial acute phase of their illness, but new problems have emerged autonomic dysfunction and hospital acquired pneumonia (often with multiresistant organisms) are now the commonest causes of death. This serial cases report presents six selected cases of tetanus, three patients acquired secondary pneumonia during treatment, among the three, two patients are elderly age 70 and 72 years old. Both of the presented patients died during treatment in the hospital. (Med J Indones 2004; 14: 117-21) |
