Federmann M, Kotzerke M
Medizinische Klinik, Städtisches Krankenhaus Singen.
Dtsch Med Wochenschr. 1989 Nov 24;114(47):1833-6. doi: 10.1055/s-2008-1066835.
12 days after an operation for pericaecal abscess due to perforation of the appendix, a 57-year-old man developed severe tetanus requiring mechanical ventilation for 37 days. Additional complications--pneumonia with septicaemia, disseminated intravascular coagulopathy, prolonged renal failure--were controlled by intensive medical measures. The tetanus was most likely of endogenous origin: Clostridium tetani occurs as a saprophyte in the gastrointestinal tract. It is recommended that tetanus immunization status of a patient should be checked before any operation on the gastrointestinal tract. If negative, prophylactic tetanus antitoxin should be administered.
一名57岁男性因阑尾穿孔导致盲肠周围脓肿接受手术后12天，发生严重破伤风，需要机械通气37天。其他并发症——肺炎伴败血症、弥散性血管内凝血、长期肾衰竭——通过强化医疗措施得到控制。破伤风很可能源于内源性：破伤风梭菌作为腐生菌存在于胃肠道。建议在对胃肠道进行任何手术前检查患者的破伤风免疫状况。如果为阴性，应给予预防性破伤风抗毒素。
