[Postoperative tetanus].

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.