Tetanus in Children: Clinical Insights and Management From a Multicenter Study in Turkey.

BACKGROUND: Although tetanus is a vaccine-preventable disease, it remains a clinical concern among unvaccinated and under-immunized children, particularly in vulnerable populations. METHODS: We conducted a retrospective multicenter case series of 5 pediatric patients diagnosed with tetanus between 2018 and 2024 at 4 tertiary care centers in Turkey. Demographic characteristics, clinical presentation, management strategies and outcomes were analyzed. RESULTS: All patients were unvaccinated migrant boys with generalized tetanus. The most common risk factor was penetrating foot injury. Prominent clinical features included muscle rigidity, spasms, airway compromise and autonomic instability. All patients required pediatric intensive care, and 3 required mechanical ventilation. Tetanus immune globulin, antibiotics and multimodal sedation were administered to all cases. No mortality was observed, and all patients recovered with supportive care and subsequent immunization. CONCLUSIONS: This case series highlights that tetanus remains a preventable, yet persistent threat among unvaccinated migrant children. Strengthening targeted vaccination strategies and maintaining a high index of clinical suspicion are essential to prevent morbidity in at-risk pediatric populations.