Even today, tetanus is encountered in the industrialised countries, in
particular in the case of patients who have inadequate immunization p
rotection. In a case encountered in 1991, the course and treatment of
this condition are described and compared with the management of seven
teen patients seen over the preceding 20 years. Basic treatment compri
ses the administration of tetanus antitoxin in order to bind free toxi
n circulating in the blood. In the severe forms of the disease, suppor
tive intensive treatment measures, including the administration of mus
cle relaxants and sedatives, artificial respiration and possibly trach
eotomy may be required in addition. More modern approaches include the
administration of magnesium sulphate and baclofen.