Neonatal tetanus, a persistent vaccine-preventable disease

Neonatal tetanus is a vaccine-preventable disease caused by Clostridium tetani, a Gram-positive, strictly anaerobic, spore-forming bacillus that colonizes unsterilized objects and thus infects wounds. Different strategies of maternal vaccination during pregnancy have been implemented, achieving a significant reduction in the disease, although not its eradication. We present the case of a newborn with maternal and perinatal risk factors who was admitted to our hospital with a diagnosis of late-onset sepsis and neuroinfection. She presented with abnormal movements and muscle rigidity and received antibiotic treatment, with no response. Subsequently, due to progression of symptoms suggestive of neonatal tetanus, she was treated with tetanus immunoglobulin, also without improvement, requiring repeated and increasing doses. Therefore, we can conclude that neonatal tetanus, while rare, still exists in our region, and carries a high mortality despite optimal care and treatment. This case highlights the role of vaccination in reducing its incidence and associated mortality. Strategies should be developed to increase vaccination rates in children, adolescents, and pregnant women.