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Itching In arm and dizziness after T.T injection.

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Dear Doctor

I have given T.T injection to a very close friend in her arms. While injecting she moved a little bit hence 25% medicine injected were leaked out. It was about 10 days back. Since injection taken she is complaining there is itching over injected area daily (not an abnormal itching). A small clot is found over injected area. She is having slight giddiness occasionally. Is this all due to inexperience of applying injection or will it have such side effects to the patient. Please advice. It is normal T.T. Vaccine. the injection is given due to a knife cut in her thumbs 1o days ago.

Regards Ganesh

Category: Family Physician-GP

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Category: HIV- AIDS Specialist
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Hello.
Thank you for posting your query at DoctorSpring.com
I understand your concern.
The giddiness is not related to the injection.
For that we have to evaluate her and check her blood sugar levels, her BP, and if she is anemic.
Regarding the TT, 25 % leaked out, it won't cause any issues, however the protection against the bacteria definitely won't be proper, since the entire dose is required to mount a good immunity response. However its been 10 days, and she has shown any symptoms of tetanus, so there is again nothing to worry about.
The itching and the clot will settle down on its own. If there is a lot of itching then an anti-histaminic such as Tab. Levocetrizine 5 mg once daily at bed time can be taken.
If her giddiness is persistent, you need to check her hemoglobin,BP, and blood sugar level.
Feel free to discuss further,
Regards.


Patient replied :

Doctor ,,,,, Thanks for your kind reply.
For the past couple of days she is complaining about her left ears, mis-behaving with abnormal noises, also she is getting echo of all sounds nearby and also her own communication. Will there be any link to her giddiness? What is this systom called as. The hearing volume in her left ears also gone down little. Will this symptom lead to any serious problem. She has fear that something may happen to her ears and offcourse to her life due to giddiness.
Please let me know cause and seriousness of these symptoms.
Regards/ Ganesh


Hello.
Thank you for the follow up.
Ringing in the ear along with echo and giddiness can indicate a range of conditions in the ear from otitis media to middle ear infections. This is once again unrelated to the injection. However this needs a thorough ENT examination, where the doctor will check the middle ear with the help of an otoscope to rule out any inflammation/wax/fungal infection ( e.t.c ). This can happen due to a hole in the tympanic membrane, which can again be due to acute or chronic ear infection.
If it is treated in the first stage itself without much delay. then this problem will disappear. The doctor needs to do some hearing evaluation tests along with otoscopy as i mentioned.
Please follow it up with an ENT opinion.
Regards.


Patient replied :

Noted doctor.
Let me introduce I am Indian working in Lagos, Nigeria.
Approached yesterday an ENT specialist in Lagos, described all the same thing what I have explained above. The doctor prescribed Tab Stugergon (Cinnarizine 25 mg perr tablet) to have for 7 days 3 times daily. After a course of this tablet to meet him again then he will let us know whether thorough check up is required or not. If required he siad an MRI scanning will be needed.
Please let me have your opinion because we are living in Nigeria.
Regards Ganesh


Hello Mr. Ganesh.
Yes stugeron is the first line of management that is recommended for patients who present with giddiness, provided hypertension has been ruled out and is not contributory.
If it settles down, then you can avoid the scanning.
But mostly the issue with vertigo and giddiness like symptoms are, they tend to be clingy and stay for some time. Hence i will advise you to continue the medicine for a few days at least. MRI can always be resorted too, just to see if everything is fine with the sinuses and the middle ear. As of now continue with stugeron and let me know in a couple of days time about her symptoms.
Regards.


Dr. Jaydeep Tripathy
Category: HIV- AIDS Specialist
Experience: 
MBBS from Sri Ramachandra University in December 2011
M.Med (Family Medicine) - TNMGR University, Chennai
MBA-MPH in Public Health in March 2016, SRM University
Finished AFIH in March 2016, SRM University
MRCP ( UK ), Internal Medicine, Royal College of Physicians, June 2016
Fellowship in Diabetology from Martin Luther University in January 2017

Currently Resident Physician, in MD Radiodiagnosis - Kamakshi Memorial Hospital, Chennai
Dr. Jaydeep Tripathy and 4 other Medical Specialists are ready to help you

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