A case of iliopsoas hematoma as a complication of tetanus in a patient who did not receive anticoagulant therapy

Nagasawa, Hiroki; Muramatsu, Ken-ichi; Takeuchi, Ikuto; Kushida, Yoshihiro; Jitsuiki, Kei; Shitara, Jun; Ohsaka, Hiromichi; Omori, Kazuhiko; Oode, Yasumasa; Yanagawa, Youichi

BACKGROUND: The specific clinical feature of tetanus is whole body muscle spasms. These spasms are intensely painful and sometime lead to some injuries. Vertebral fractures have been reported as a common complication of tetanus, however iliopsoas hematoma is a rare complication. We describe a case of iliopsoas hematoma in a tetanus patient who had not been treated with any anticoagulant or antiplatelet agents. CASE PRESENTATION: A 72-year-old female patient was transferred to our hospital 7 days after the onset of tetanus. An iliopsoas hematoma was identified in her right iliopsoas muscle on computed tomography. There was no extravasation; thus, the hematoma improved with conservative therapy. There were no episodes that suggested a bleeding tendency, or no factors associated with hemorrhagic conditions. CONCLUSION: This is the first report of iliopsoas hematoma as a complication in a tetanus patient who did not received anticoagulation therapy. The possibility of IPH as a complication of tetanus should be considered before and during the administration of anticoagulation therapy.