Generalised tetanus managed with continuous diazepam infusion in a resource-constrained setting: a case report

Abstract

Introduction: Tetanus is a neuromuscular illness caused by Clostridium tetani, which is an anaerobic spore-forming bacteria, found in soil and faeces. Even though C. tetani is present everywhere, mostly found in poor and crowded areas. Primary vaccination campaigns have led to a decline in the prevalence of tetanus in developed nations. If tetanus is identified and treated early, the prognosis is favourable. It is important to raise awareness of this potentially fatal and debilitating illness. Method: We present a case of a 50-year-old male diagnosed with generalised tetanus purely on clinical grounds and successfully managed with prolonged diazepam infusion with maintenance of safety and ventilatory support, cost-effective ICU care and reducing the cost of treatment in the absence of immunoglobulin. Results: The patient showed gradual improvement with diazepam infusion and ICU care and was discharged with complete resolution of tetanic spasms by the time of discharge. Conclusion: Timely diagnosis, strong clinical suspicion, and quality ICU care can ensure recovery in this rare but potentially fatal disease. © The Author(s) 2025.