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  1. C. L. Thwaites
  1. University of Oxford Wellcome Trust Clinical Research Unit, Centre for Tropical Diseases, 190 Ben Ham Tu, Ho Chi Minh City, Vietnam; E-mail: lthwaites{at}



Tetanus is a rare disease in the UK (about 6 cases per year) but it is an important disease world-wide – approximately 500 000 neonates, and similar numbers of adults and children, die from tetanus every year (Dietz et al. 1996). Although much is now known about the pathophysiology of the disease, rather few advances have been made in treatment and the mortality remains high despite modern intensive care facilities. This article will present a general review of the literature concerning tetanus. It will focus on what evidence there is for optimal diagnosis and management, and highlight the key clinical issues that concern the physician when caring for a patient with tetanus


Tetanus is caused by a neurotoxin produced by the bacterium Clostridium tetani (C. tetani), which is an ubiquitous organism found in the soil, and human and animal faeces, throughout the world. The bacteria persist as resilient spores,

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