TITLE:
Co-Morbidity of Severe Malaria and Generalised Tetanus: A Rare Case Report
AUTHORS:
Ajayi Ajetomobi, Prisca Omolola Olanrewaju, Joshua Abidemi Owa, Emmanuel Oluwasegun Adedigba, Tunmise Tope Oladipe
KEYWORDS:
Malaria, Anaemia, Tetanus, Convulsion, Reflex Spasticity, Life-Threatening, Co-Morbidity
JOURNAL NAME:
Open Access Library Journal,
Vol.11 No.8,
August
21,
2024
ABSTRACT: A fifteen-year-old boy presented with a complex of clinical symptoms and signs of severe malaria; fever, convulsions, loss of consciousness, severe anaemia, hypoglycaemia and that of generalised tetanus; trismus, rigidity, reflex spasticity, tiny necrotic area on the plantar surface of the foot. The patient responded very poorly to intravenous artesunate, and blood transfusion among other measures for the management of severe malaria. A history of tetanus immunization could not be established. The patient was commenced on Intravenous (IV) metronidazole 500 mg 6 hourly after the wound was debrided and dressed uncovered. Anti-tetanus immunoglobulin was administered after a test dose. IV diazepam, Chlorpromazine, and Phenobarbitone were given to control convulsion and spasticity and to relieve symptoms. The glucose flow rate was strictly maintained via the IV route for the first 24 hours and subsequently, the Nasogastric (NG) tube was passed with the introduction of feeds. The patient responded drastically and was discharged after 15 days to complete his medication on an outpatient basis and tetanus immunization.