{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T20:15:19Z","timestamp":1787170519058,"version":"build-2736575974"},"reference-count":15,"publisher":"Necmettin Erbakan University Press","issue":"04","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Pediatr Intensive Care"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The aims and objectives of this study were to study clinical profile and factors affecting mortality in tetanus. This was a retrospective study of 25 tetanus patients (aged 6 months\u201312 years) admitted to pediatric intensive care unit of a tertiary center (over 3 years). In this study, 25 tetanus cases (mean age 6.6 years) were analyzed; 16 were males and 9 were females. Incubation period ranged from 2 to 30 days (mean 8.2 days), period of onset from 11 to 120\u2009hours (mean 42.8\u2009hours), and duration of spasms from 4 to 26 days (mean 14 days). The commonest portal of entry was posttrauma (52%), followed by otogenic (40%). Eighteen patients had moderate and 7 had severe tetanus. Fifteen were unimmunized and 10 were partially immunized. The commonest complaints were trismus and spasms (100%), hypertonia (72%), fever (60%), dysphagia (48%), and neck stiffness (44%). Eight patients required primary tracheostomy and 11 required primary endotracheal intubation. Complications encountered were pneumonia (58%), conjunctivitis (41%), gastrointestinal bleed (37.5%), urinary infection (33%), acute kidney injury (AKI) following rhabdomyolysis (33%), sepsis (29%), disseminated intravascular coagulation (DIC) (25%), bedsores (25%), and acute respiratory distress syndrome (ARDS) (20%). Oral diazepam was most commonly used, followed by midazolam, vecuronium, and magnesium sulfate. Mortality rate was 32% (five moderate and three severe cases died). Short period of onset (less than 48\u2009hours), AKI following rhabdomyolysis, sepsis, DIC, ARDS, and inotrope need were significantly associated with higher mortality. It is concluded that the commonest portal of entry was posttrauma. None of the patients was completely immunized. Short period of onset, AKI, sepsis, DIC, ARDS, and inotrope need predicted a higher mortality.<\/jats:p>","DOI":"10.1055\/s-0040-1715854","type":"journal-article","created":{"date-parts":[[2020,9,7]],"date-time":"2020-09-07T18:47:08Z","timestamp":1599504428000},"page":"256-263","source":"Crossref","is-referenced-by-count":6,"title":["Clinical Profile and Outcome of Pediatric Tetanus at a Tertiary Care Center"],"prefix":"10.53391","volume":"10","author":[{"given":"Shruti A.","family":"Mondkar","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Seth G.S. Medical College and King Edward Memorial Hospital, Mumbai, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milind S.","family":"Tullu","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Seth G.S. Medical College and King Edward Memorial Hospital, Mumbai, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chandrahas T.","family":"Deshmukh","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Seth G.S. Medical College and King Edward Memorial Hospital, Mumbai, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramya","family":"SrinivasaRangan","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Seth G.S. Medical College and King Edward Memorial Hospital, Mumbai, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mukesh","family":"Agrawal","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Seth G.S. Medical College and King Edward Memorial Hospital, Mumbai, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"31409","published-online":{"date-parts":[[2020,9,7]]},"reference":[{"key":"ref1","first-page":"1432","volume-title":"Tetanus (Clostridium tetani)","author":"S Arnon","year":"2016"},{"issue":"03","key":"ref4","first-page":"170","article-title":"Pediatric and neonatal tetanus: a hospital based study at eastern Nepal","volume":"10","author":"P Poudel","year":"2008","journal-title":"Nepal Med Coll J"},{"issue":"10","key":"ref5","doi-asserted-by":"crossref","first-page":"881","DOI":"10.1007\/s13312-015-0736-5","article-title":"Tetanus--a tale of 50 years","volume":"52","author":"P Singh","year":"2015","journal-title":"Indian Pediatr"},{"issue":"07","key":"ref7","first-page":"765","article-title":"Experience of pediatric tetanus cases from Mumbai","volume":"37","author":"M S Tullu","year":"2000","journal-title":"Indian Pediatr"},{"issue":"02","key":"ref8","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1186\/cc13797","article-title":"Pharmacological management of tetanus: an evidence-based review","volume":"18","author":"C Rodrigo","year":"2014","journal-title":"Crit Care"},{"issue":"01","key":"ref9","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1093\/tropej\/fmx020","article-title":"Post-neonatal tetanus in a PICU of a developing economy: intensive care needs, outcome and predictors of mortality","volume":"64","author":"S K Angurana","year":"2018","journal-title":"J Trop Pediatr"},{"issue":"11","key":"ref10","first-page":"1369","article-title":"A study of childhood tetanus in post-neonatal age group in Delhi","volume":"31","author":"T Mondal","year":"1994","journal-title":"Indian Pediatr"},{"issue":"03","key":"ref11","first-page":"641","article-title":"Two years' study of tetanus cases in a paediatric intensive care unit","volume":"32","author":"F Naseem","year":"2016","journal-title":"Pak J Med Sci"},{"issue":"03","key":"ref12","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1258\/td.2012.110445","article-title":"Tetanus - still a scourge in the 21st century: a paediatric hospital-based study in India","volume":"42","author":"K Mishra","year":"2012","journal-title":"Trop Doct"},{"issue":"09","key":"ref13","doi-asserted-by":"crossref","first-page":"1015","DOI":"10.1007\/s12098-015-2015-9","article-title":"Re-emergence of tetanus: epidemiological features, clinical profile and outcome from South India","volume":"83","author":"V K Gowda","year":"2016","journal-title":"Indian J Pediatr"},{"key":"ref14","volume-title":"Epidemiology and Prevention of Vaccine-Preventable Diseases. In: Hamborsky J, Kroger A, Wolfe S, eds. 13th edn","year":"2015"},{"key":"ref15","first-page":"2399","volume-title":"Disseminated intravascular coagulation","author":"J Scott","year":"2016"},{"key":"ref16","first-page":"528","volume-title":"Respiratory distress and failure","author":"A P Sarnaik","year":"2016"},{"issue":"04","key":"ref17","first-page":"37","article-title":"Study of tetanus cases in intensive care unit of pediatrics","volume":"4","author":"W Anwar","year":"2018","journal-title":"World J Pharmaceut Med Res"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1136\/bmj.3.5877.423","article-title":"Hypotension in tetanus","volume":"3","author":"J L Corbett","year":"1973","journal-title":"BMJ"}],"container-title":["Journal of Pediatric Intensive Care"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0040-1715854.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T19:50:03Z","timestamp":1758138603000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0040-1715854"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9,7]]},"references-count":15,"journal-issue":{"issue":"04","published-online":{"date-parts":[[2021,11,1]]},"published-print":{"date-parts":[[2021,12]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0040-1715854","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["2146-4618","2146-4626"],"issn-type":[{"value":"2146-4618","type":"print"},{"value":"2146-4626","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,9,7]]}}}