Generalized Tetanus Revealing an Occult Esophageal Button Battery in a Fully Vaccinated Infant: An Exceptional Case
Tétanos Généralisé Révélant une Pile Bouton Œsophagienne Occulte chez un Nourrisson Correctement Vacciné : Un Cas Exceptionnel
DOI:
https://doi.org/10.5281/zenodo.17624072Keywords:
Tetanus, Button Battery, Esophageal Foreign Body, Infant, Vaccine Failure, DiagnosisAbstract
RÉSUMÉ
Le tétanos est exceptionnel chez les enfants correctement vaccinés. Nous rapportons le cas singulier d’un nourrisson de 24 mois, ayant reçu toutes les doses de vaccin antitétanique selon le calendrier national, hospitalisé pour un tétanos généralisé. Le tableau associait opisthotonos, trismus et dysphagie, sans porte d’entrée cutanée identifiable. Le bilan radiologique découvrit fortuitement une pile bouton enclavée dans l’œsophage thoracique. Lors de l'endoscopie, la pile migra spontanément dans l'estomac puis fut éliminée naturellement. L'évolution fut favorable sous immunoglobulines et sédation. Ce cas rare alerte sur la nécessité de rechercher une porte d'entrée muqueuse occulte, notamment un corps étranger œsophagien, devant tout tétanos, y compris en contexte de vaccination complète.
ABSTRACT
Tetanus is exceptionally rare in correctly vaccinated children. We report the singular case of a 24-month-old infant who had received all scheduled doses of tetanus-containing vaccine, hospitalized for generalized tetanus. The clinical presentation featured opisthotonos, trismus, and dysphagia, with no identifiable cutaneous portal of entry. Radiological workup incidentally discovered a button battery lodged in the thoracic esophagus. During endoscopy, the battery migrated spontaneously into the stomach and was later eliminated naturally. The outcome was favorable with immunoglobulin therapy and sedation. This rare case highlights the critical need to investigate an occult mucosal portal of entry, specifically an esophageal foreign body, in any case of tetanus, including in fully vaccinated individuals.
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Copyright (c) 2025 Ndèye Fatou Thiam, Richard Edouard Alain Deguenonvo, Jordy Mandabrandja, Aminata Mbaye, Abdoul Niane, Mame Sanou Diouf
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