FATAL TETANUS WITH BRAIN‐STEM INVOLVEMENT AND MYOCARDITIS IN AN EX‐SERVICEMAN

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Abstract
An ex‐serviceman, who had been fully immunized against tetanus In the Second World War, developed fatal tetanus, in spite of a booster dose of tetanus toxoid and 4,000,000 units of procaine penicillin per day. Clinical signs of brain‐stem involvement were supported by histological findings of neuronal damage. Myocarditis was also found. The changes In the brain‐stem and in the heart were considered to be direct effects of tetanus toxins. The case history shows that a single booster dose of tetanus toxoid may not be protective 25 years after primary immunization, and that antibiotic prophylaxis may be ineffective against tetanus.