PT  - JOURNAL ARTICLE
AU  - Sébastien Strypstein
AU  - Simon Claeys
AU  - Bart Smet
AU  - Paul Pattyn
TI  - Forgotten pathogen: tetanus after gastrointestinal surgery
AID  - 10.1136/bcr-2019-229701
DP  - 2019 Aug 01
TA  - BMJ Case Reports
PG  - e229701
VI  - 12
IP  - 8
4099  - http://casereports.bmj.com/content/12/8/e229701.short
4100  - http://casereports.bmj.com/content/12/8/e229701.full
SO  - BMJ Case Reports2019 Aug 01; 12
AB  - A previously healthy 79-year-old woman underwent an urgent laparotomy and resection of a strangulated loop of small bowel. On the second postoperative day, she developed symptoms suspicious for postoperative tetanus. A transfer to the intensive care unit was necessary for aggressive supportive therapy. The patient required 5 months of intensive physiotherapy and rehabilitation and was successfully discharged home. New cases of tetanus have become rare in developed countries. This potentially lethal disease affects both non-immunised and inadequately immunised patients. The occurrence of tetanus after gastrointestinal surgery is extremely rare. Prevention is key and can be achieved with correct immunoprophylaxis. Older patients are often inadequately immunised. Should tetanus immunoprophylaxis routinely be checked for elderly patients undergoing gastrointestinal surgery? Or can we limit the immunisation to severe cases of ischaemic bowel injury with necrosis and/or soiling of the abdominal cavity?