Management of tetanus in the elderly.

BACKGROUND Tetanus is primarily a disease of the elderly. Both the incidence and the case-fatality rates are higher in the elderly population. Physicians need to be aware of special needs concerning the treatment of tetanus in this population. METHODS A comprehensive review of the literature concerning the treatment of tetanus was undertaken. Using the key words "tetanus," "geriatric," "elderly," and "aged," the MEDLINE files were searched from 1985 to the present. Articles dating before 1985 were accessed by cross-referencing the more recent articles. RESULTS AND CONCLUSIONS Once the diagnosis of tetanus is suspected, intensive, expectant management is necessary. The patient should receive intensive care with treatment aimed at prevention of muscle spasms, prevention of respiratory tract and metabolic complications, and neutralization of circulating toxin. Potential complications of tetanus include pulmonary embolus, aspiration pneumonia, malnutrition, and pressure sores.