A case report of severe tetanus infection in a rural ICU setting: Role of intravenous magnesium

ABSTRACT: Tetanus is a life-threatening condition often complicated by repetitive spasms, dysautonomia, and neuromuscular respiratory failure, contributing to high mortality in its severe form. Benzodiazepines and neuromuscular blockers used to treat muscle spasms pose a high risk of respiratory failure requiring mechanical ventilation, which increases hospital stay and morbidity and is inaccessible for many. Magnesium sulfate, a cheap and widely available medication in all urban and rural health centers used for the treatment of eclampsia, can be used to control muscle spasms and dysautonomia. In our case report, the use of magnesium sulfate was found to be effective in reducing muscular spasms along with other supportive medications, leading to better control of dysautonomia, withdrawal from mechanical ventilation, and shorter ICU stays. Keyword: Tetanus, Trismus, Magnesium, Ventilator, Vaccine