Stellate Ganglion Block for Treatment of Refractory Sympathetic Storm in Severe Tetanus: A Case Report.
Yuxin Xiao, Yuan Gong, Kelin Chen et al.
✦ AI-curated · Sources linked
Case in brief
A 67-year-old man developed severe tetanus after a bamboo-skewer puncture wound to his left middle finger; the foreign body remained embedded for 3 days before he removed it himself, and he received no systematic medical care afterward. He presented with neck stiffness, dysphagia, pallor, and cyanosis. Despite intubation, wound debridement, tetanus toxoid vaccine, human tetanus immunoglobulin, and standard sedatives, analgesics, and muscle relaxants, recurrent convulsions and sympathetic storm persisted. An ultrasound-guided left stellate ganglion block was performed and the sympathetic storm was aborted.
What made this case unusual
The sympathetic storm was refractory to standard pharmacotherapy but was aborted after ultrasound-guided stellate ganglion block, used as rescue therapy in severe tetanus.
Diagnostic / clinical pearl
In severe tetanus with sympathetic hyperactivity that persists despite standard treatment, stellate ganglion block may be considered as a rescue option; this single case does not establish causality or general applicability.