Toxic shock syndrome after nasal surgery: is prevention possible? A case report and review of the literature.
Toxic shock syndrome (TSS), is an acute illness with four major criteria: involvement of multiple organ systems, fever greater than 38.9 degrees C, hypotension or shock and rash with subsequent desquamation. TSS was first reported by Todd et al. in 1978, and is a rare complication of staphylococcal infection. Although it at first was thought to be a childhood disease and an illness of menstruating women using intravaginal tampons, it has now been described as a complication of minor surgery, burns and minimal skin infections (Reingold et al., 1982; Jacobson et al., 1983). More than 2800 cases have been reported at the Centers for Disease Control (CDC) in Atlanta (Reingold, 1985). Jacobson and Kasworm (1986) estimate the incidence after nasal surgery to be 16.5 per 100.000, which in fact is higher than the incidence in women of menstrual age using intravaginal tampons. TSS usually occurs within 24-48 hours after surgery, often starting with nausea and vomiting. Although the syndrome can be lethal or can have troublesome sequelae, as prolonged weakness fatigue and neuropsychological disturbances, complete recovery is often the case.
de Vries
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Dept. of O.R.L., Free University Amsterdam, The Netherlands.
van der Baan
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D000328:Adult; D005260:Female; D006801:Humans; D009666:Nose / Q000601:surgery*; D011183:Postoperative Complications / Q000517:prevention & control*; D012772:Shock, Septic / Q000209:etiology / Q000517:prevention & control*