doiSerbia

Did we forget tetanus?

Alempijević Đorđe (Institut za sudsku medicinu, Medicinski fakultet, Beograd)
Baralić Ivanka (Institut za sudsku medicinu, Medicinski fakultet, Beograd)
Kiurski Milosav (Služba za patologiju, Kliničko-bolnički centar 'Zemun', Beograd)
Ječmenica Dragan (Institut za sudsku medicinu, Medicinski fakultet, Beograd)
Pavlekić Snežana (Institut za sudsku medicinu, Medicinski fakultet, Beograd)
Živković Vladimir (Institut za sudsku medicinu, Medicinski fakultet, Beograd)
Savić Slobodan (Institut za sudsku medicinu, Medicinski fakultet, Beograd)

Introduction. Currently, in our country (Republic of Serbia) tetanus is a rarely occurring disease, mainly affecting people older than 65 years of age. A small number of reported cases is mainly due to appropriate immunization. Therefore, each case of tetanus may be considered as failure of health care system to provide adequate immunization. Case outline. A 71-year-old woman was injured in her garden. She sustained laceration in the left coccygeal region. The next day the wound was treated by a surgeon, but tetanus postexposure prophylaxis was not administrated. On the fifth day following the incident, the symptoms and signs of tetanus became apparent, and the patient died two days later. Postmortem examination revealed the wound that was not adequately treated, since there was a foreign body and a dressing inserted in the wound. Signs of acute (aerobic) infection were also present. Conclusion. Tetanus is a severe, potentially lethal disease that is absolutely preventable. Mistakes in immunization and surgical treatment of the wound can be considered as medical malpractice.

Keywords: tetanus, immunization, death, medico-legal aspects