An Unusual Case of Chronic Relapsing Tetanus Associated with Mandibular Osteomyelitis
An Unusual Case of Chronic Relapsing Tetanus Associated with Mandibular Osteomyelitis
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DOI：
10.2169/internalmedicine.48.2136
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发表时间：
2009-01-01
影响因子：
1.2
通讯作者：
Shoji, Mikio
中科院分区：
文献类型：
--
作者：
Wakasaya, Yasuhito;Watanabe, Mitsunori;Shoji, Mikio
一位55岁男性因颈部恶性淋巴瘤接受放射治疗。治疗八年后，他患上了破伤风。看来放射治疗导致了下颌骨坏死，并且该病变可能是破伤风的感染病灶。青霉素G治疗在急性期非常有效，甲硝唑长期给药可防止疾病复发。然而，尽管注射了破伤风类毒素，但由于感染灶不能完全清除，当停止甲硝唑给药时，破伤风症状复发。这是第一次报告的慢性复发性破伤风与放射性引起的下颌骨骨髓炎，并表明，破伤风可以发生由于下颌骨的重点，但甲硝唑的长期管理可以防止复发。
A 55-year-old man underwent radiation therapy due to malignant lymphoma of the neck. Eight years after the therapy he developed tetanus. It appears that the radiation therapy resulted in mandibular necrosis, and that this lesion may have been the infectious focus of tetanus. Treatment with penicillin G was very effective in the acute stage, and chronic administration of metronidazole prevented relapse of the disease. However in spite of injections of tetanus toxoid, symptoms of tetanus returned when the administration of metronidazole was discontinued because the infectious focus could not be completely removed. This is the first report of chronic relapsing tetanus associated with radiation-induced mandibular osteomyelitis, and demonstrates that tetanus can occur due to mandibular focus but the chronic administration of metronidazole can prevent relapse.