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Iliopsoas hematoma as a complication of tetanus
Author(s) -
Ishii Nobuyuki,
Mochizuki Hitoshi,
Shiomi Kazutaka,
Nakazato Masamitsu
Publication year - 2019
Publication title -
neurology and clinical neuroscience
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.125
0ISSN - 2049-4173
DOI - 10.1111/ncn3.12241
Subject(s) - iliopsoas , medicine , hematoma , iliopsoas muscle , incidence (geometry) , surgery , tetanus , complication , abscess , physics , optics , immunology , vaccination
Background Iliopsoas hematoma is a rare but serious bleeding event that occurs during anticoagulation therapy. Due to lack of previous reports of clinical data, incidence and characteristics of iliopsoas hematoma during tetanus management, including anticoagulation prophylaxis for venous thromboembolism, remain unclear. Aim To evaluate the incidence of iliopsoas hematoma in tetanus and identify clinical factors that would help in its detection. Materials and Methods We conducted a retrospective descriptive study and evaluated the clinical courses of patients with iliopsoas hematoma as a case series. Patient data were collected by reviewing medical charts. Results Among 21 patients, four (19%) developed iliopsoas hematoma during the clinical course of tetanus. A case series of these four patients revealed that all had progressive anemia; furthermore, D‐dimer levels continued increasing or did not decrease in these patients despite them receiving anticoagulation therapy. Conclusion The incidence of tetanus‐related iliopsoas hematoma was higher than that of anticoagulation‐related iliopsoas hematoma. Therefore, clinicians should carefully consider the indication of prophylaxis for venous thromboembolism in patients with tetanus. Progressive anemia and increased D‐dimer level may indicate iliopsoas hematoma in patients with tetanus.