背景：在发达国家，广泛的疫苗接种显著减少了破伤风病例的数量。今天,在日本等发达国家，大多数破伤风病例会影响老年人和免疫接种不足的人群。由于疫苗接种被认为在预防破伤风方面几乎100%有效，年轻的破伤风，免疫个体被认为不太可能。然而,据报道，在年轻的充分免疫的个体中，有意外的破伤风感染。
方法：我们在此描述了一名20岁的免疫女性，她在接受右脚穿刺伤后开始出现三联肌和疼痛性肌肉痉挛来急诊就诊。体格检查显示体温升高（38°C），刺耳,右腿和颈部肌肉痉挛,和她右脚脚底的刺伤.入住重症监护病房后出现呼吸困难，患者接受了插管和机械通气.她在重症监护六天后完全康复。
结论：本病例清楚地提醒人们，破伤风可能仍然发生在年轻人身上，免疫个体。有免疫史的患者可能比没有免疫史的患者预后更好。
BACKGROUND: Widespread vaccinations have significantly decreased the number of tetanus cases in developed countries. Today, most cases of tetanus affect the elderly and those with inadequate immunization in developed countries such as Japan. As vaccinations were believed to be nearly 100% effective in preventing tetanus, tetanus in young, immunized individuals were considered unlikely. However, unexpected tetanus infection has been reported in young adequately immunized individuals.
METHODS: We herein describe a 20-year-old immunized female who visited our emergency department with trismus and painful muscle spasms that started after receiving a puncture wound to her right foot. A physical examination revealed an elevated body temperature (38°C), trismus, muscle spasms in her right leg and neck, and a puncture wound at the sole of her right foot. Following the development of dyspnea after admission to the intensive care unit, the patient was intubated and mechanically ventilated. She fully recovered after six days in intensive care.
CONCLUSIONS: The present
case serves as a stark reminder that tetanus may still occur in young, immunized individuals. Patients with a history of immunization may have a better prognosis than those with no immunizations.
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