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South African Journal of Child Health

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Neonatal tetanus – uncommonly encountered radiological manifestations

Aadil Ahmed

Abstract


Neonatal tetanus is a rare, acute, occasionally fatal disease, the incidence of which has greatly diminished with routine immunisation. The radiological features are seldom encountered nowadays. Neonatal tetanus is still prevalent in some developing countries. We present a case of a neonate who developed some of the complications and radiological features described in cases of neonatal tetanus. Tetanus is an acute, often fatal, disease caused by an exotoxin produced by the Gram-positive bacterium Clostridium tetani. It is characterised by generalised rigidity and convulsive spasms of the skeletal muscles. The incubation period ranges from 3 to 21 days – usually about 8 days. Neonatal tetanus is a form of generalised tetanus that occurs without protective passive immunity. It usually occurs as a result of infection of the unhealed umbilical stump, particularly when the stump is cut with an unsterile instrument. With the advent of routine childhood immunisation, there has been a marked decrease in the incidence of tetanus. Neonatal tetanus, however, is still prevalent in some developing countries. There are no laboratory findings characteristic of tetanus. The diagnosis is entirely clinical and does not depend on bacteriological confirmation.




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