Tetanus in a subcutaneous drug abuser: ineffectiveness of intrathecal baclofen.

Abstract

This report discusses the issues involved in the diagnosis and management of tetanus. A 29-year-old female with a history of illicit drug use presented with progressive tetany secondary to an abscess on her forearm from subcutaneous injections. She was managed in the intensive care unit for 29 days and was discharged to the ward. The main issue in her management was control of tetanic episodes interfering with ventilation and resistant to intrathecal baclofen. Other therapeutic strategies aimed at reducing spasms included magnesium, atracurium, pancuronium, midazolam, propofol and dantrolene. We conducted searches on Medline, PUBMED and the Cochrane Database of Systematic Reviews using the following terms: tetanus, treatment, therapy, drug abuse, magnesium, baclofen and human anti-tetanus immunoglobulin (hAIG). The current strategies involved in treating tetanus are discussed.

• Authors: R M Thomas, M C Bellamy
• Journal: Anaesthesia and intensive care (Anaesth Intensive Care) Vol. 34 Issue 6 Pg. 811-5 (Dec 2006) ISSN: 0310-057X [Print] United States
• PMID: 17183905 (Publication Type: Case Reports, Journal Article, Review)

Chemical References

• Muscle Relaxants, Central
• Baclofen

Topics

• Adult
• Baclofen (administration & dosage)
• Clostridium tetani (drug effects)
• Drug Administration Routes
• Female
• Heroin Dependence (complications)
• Humans
• Injections, Spinal
• Muscle Relaxants, Central (administration & dosage)
• Spasm (etiology, therapy)
• Tetanus (drug therapy, etiology)
• United States