Classification of Veronesi for Tetanus

Description

Veronesi classified patients with tetanus based on the severity of the clinical syndrome. This can help separate patients into prognostic groups and can identify patients who may benefit from more aggressive or novel therapies. The author is from the University of Sao Paulo in Brazil.

Parameters:

(1) incubation period in days

(2) progression period in hours from time of onset

(3) frequency of spasms

(4) muscular hypertonicity

(5) dysphagia

(6) apneic attacks

(7) respiratory insufficiency

(8) efficacy of sedatives and muscle relaxants

(9) fever

Parameter	Mild	Very Severe
incubation period	> 10 days	< 10 days
progression	> 48 hours	< 48 hours
spasms	none to mild	severe
muscular hypertonicity	none to mild	severe
dysphagia	none	severe
apneic attacks	none	severe
respiratory insufficiency	none	severe
efficacy of drugs	very good	poor
fever	none	high

Patients with moderate to severe disease show changes intermediate between mild and very severe disease.

Clinical Classification	Mortality Rate
mild	none or very low
severe	20-40%
very severe	50 – 90%

Patients likely to have very severe disease with high mortality rates:

(1) neonates

(2) elderly

(3) post-abortion

(4) tetanus in a drug addict

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Classification of Veronesi for Tetanus

Description

Specialty