Generalized tetanus complicated with Takotsubo-cardiomyopathy in a
septuagenarian following a laceration injury with soil contamination – a case report
Dublin Core
Title
Generalized tetanus complicated with Takotsubo-cardiomyopathy in a
septuagenarian following a laceration injury with soil contamination – a case report
septuagenarian following a laceration injury with soil contamination – a case report
Subject
Tetanus, Elderly, Vaccination, Post exposure prophylaxis, Cardiac complications, Takotsubo- cardiomyopathy
Description
Abstract
Background Tetanus is a clinical rarity due to the successful globally adopted childhood vaccination programme.
The rising elderly population in the United Kingdom creates a subset of individuals whom are prone to develop
Tetanus as they preceded this vaccination drive.
Case summary A 76 year old Caucasian lady presented with a soil contaminated laceration injury on her knee
following a fall. Though she received urgent assessment and wound care, the relevance of the injury in the backdrop
of her age was not appreciated and her tetanus post exposure prophylaxis was overlooked. She readmitted seeking
further management 1 week later with an infected wound with Trismus and clinical features favoring Generalized
tetanus. During her stay she developed Takotsubo-cardiomyopathy with congestive cardiac failure and required
prolonged care in the intensive unit with mechanical ventilation and rehabilitation before being discharged home.
Conclusion First contact physicians should have a greater appreciation of the types of injuries and at-risk individuals
who are more prone to develop tetanus upon exposure to ensure early and appropriate identification. There should
be greater situational awareness with regard to the elderly in view of their heightened risk of development of tetanus
specially those born before the vaccination drive. Knowledge regarding post exposure prophylaxis measures for
tetanus should be regularly updated using local guidance to ensure awareness, so as to despite its rarity Tetanus
remains an adequately appreciated disease.
Keywords Tetanus, Elderly, Vaccination, Post exposure prophylaxis, Cardiac complications, Takotsubo-
cardiomyopathy
Background Tetanus is a clinical rarity due to the successful globally adopted childhood vaccination programme.
The rising elderly population in the United Kingdom creates a subset of individuals whom are prone to develop
Tetanus as they preceded this vaccination drive.
Case summary A 76 year old Caucasian lady presented with a soil contaminated laceration injury on her knee
following a fall. Though she received urgent assessment and wound care, the relevance of the injury in the backdrop
of her age was not appreciated and her tetanus post exposure prophylaxis was overlooked. She readmitted seeking
further management 1 week later with an infected wound with Trismus and clinical features favoring Generalized
tetanus. During her stay she developed Takotsubo-cardiomyopathy with congestive cardiac failure and required
prolonged care in the intensive unit with mechanical ventilation and rehabilitation before being discharged home.
Conclusion First contact physicians should have a greater appreciation of the types of injuries and at-risk individuals
who are more prone to develop tetanus upon exposure to ensure early and appropriate identification. There should
be greater situational awareness with regard to the elderly in view of their heightened risk of development of tetanus
specially those born before the vaccination drive. Knowledge regarding post exposure prophylaxis measures for
tetanus should be regularly updated using local guidance to ensure awareness, so as to despite its rarity Tetanus
remains an adequately appreciated disease.
Keywords Tetanus, Elderly, Vaccination, Post exposure prophylaxis, Cardiac complications, Takotsubo-
cardiomyopathy
Creator
Sareesh Bandapaati1*, Rayno Navinan Mitrakrishnan2
, Mazharul Islam3
and Usman Memon4
, Mazharul Islam3
and Usman Memon4
Source
https://doi.org/10.1186/s12245-024-00751-w
Date
2024
Contributor
Peri Irawan
Format
PDF
Language
ENGLISH
Type
TEXT
Files
Collection
Citation
Sareesh Bandapaati1*, Rayno Navinan Mitrakrishnan2
, Mazharul Islam3
and Usman Memon4, “Generalized tetanus complicated with Takotsubo-cardiomyopathy in a
septuagenarian following a laceration injury with soil contamination – a case report,” Repository Horizon University Indonesia, accessed April 25, 2026, https://repository.horizon.ac.id/items/show/12520.
septuagenarian following a laceration injury with soil contamination – a case report,” Repository Horizon University Indonesia, accessed April 25, 2026, https://repository.horizon.ac.id/items/show/12520.