Survival of a Patient With Tetanus in Bhutan Using a Magnesium Infusion Managed Only by Clinical Signs

Kuenza Wangmo, Margie Teng, Richard Henker, Stephen Kinnear, Jampel Tshering, Nancy Wang

    Research output: Contribution to journalArticlepeer-review

    Abstract

    Tetanus is a life-threatening disease that continues to have a high prevalence in developing countries. Severe muscle spasms often require patients to receive tracheostomy, high-dose sedatives, and sometimes prolonged neuromuscular blockade. Magnesium sulfate (MgSO 4 ) infusion has great promise as an adjunct treatment for severe tetanus, as it may allow clinicians to decrease the dose of other sedative medications. Although the mechanism of action of MgSO 4 is not well understood, it appears to attenuate both the muscle spasms and autonomic instability associated with severe tetanus infections. However, MgSO 4 infusions are often managed based on serial measurements of serum magnesium levels and other laboratory tests such as arterial blood gases, which can be difficult to obtain in resource-poor settings. We describe a case of severe tetanus in Bhutan managed through the use of magnesium infusion titrated solely to physical examination findings.

    Original languageEnglish
    Pages (from-to)194-197
    Number of pages4
    JournalWILDERNESS & ENVIRONMENTAL MEDICINE
    Volume25
    Issue number2
    DOIs
    Publication statusPublished - 2014

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