[Perioperative management of three patients with streptococcal toxic shock syndrome].
We report the perioperative management of three patients with streptococcal toxic shock syndrome (STSS) caused by group A streptococcal infection. Three of two patients survived but one patient died from multiple organ dysfunction in spite of vigorous treatments. These patients required the treatments including administration of antibiotics, circulatory and respiratory care, surgical debridement, anticoagulant therapy for disseminated intravascular coagulation and hemofiltration. The early diagnosis and surgical intervention play a key role in the successful management of this syndrome because it has a rapid course and frequent fatal outcome. The anesthetic management of these patients should be targeted to maintain perfusion of the vital organs and to control the blood clotting disorders.
Department of Anesthesiology, Jichi Medical School, Tochigi 329-0498.
Y
Y
Nakaigawa
S
S
Akazawa
S
S
Inoue
J
J
Saitoh
T
T
Kawakami
N
N
Seo
D000328:Adult; D000758:Anesthesia; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care; D012772:Shock, Septic / Q000601:surgery*; D013290:Streptococcal Infections / Q000601:surgery*; D013297:Streptococcus pyogenes; D016896:Treatment Outcome