Atypical Tetanus in a Completely Immunized 14-Year-Old Boy

Author:

König Kai1,Ringe Hannelore1,Dorner Brigitte G.2,Diers Alexander1,Uhlenberg Birgit1,Müller Dominik1,Varnholt Verena1,Gaedicke Gerhard1

Affiliation:

1. Children's Hospital, Charité Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Germany

2. Robert Koch Institute, Microbial Toxins, Center for Biological Safety, Berlin, Germany

Abstract

We report the uncommon clinical course of tetanus in a completely immunized 14-year-old boy. His initial symptoms, which included a flaccid paralysis, supported a diagnosis of botulism. Preliminary mouse-test results with combined botulinum antitoxins A, B, and E, obtained from tetanus-immunized horses, backed this diagnosis. The change in his clinical course from paralysis to rigor and the negative, more specific, botulinum mouse test with isolated botulinum antitoxins A, B, and E, obtained from nonvaccinated rabbits, disproved the diagnosis of botulism. Tetanus was suspected despite complete vaccination. The final results of a positive mouse test performed with isolated tetanus antitoxin confirmed the diagnosis. Adequate treatment was begun, and the boy recovered completely.

Publisher

American Academy of Pediatrics (AAP)

Subject

Pediatrics, Perinatology and Child Health

Reference22 articles.

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