[Toxic shock-like syndrome presenting as phlegmon of the neck: a case report].
Toxic shock-like syndrome (TSLS) is known to progress rapidly into septic shock and multiple organ failure with necrotizing soft tissue infection and high mortality. We report a rare case of TSLS of the head and neck. A 55-year-old man reporting redness and swelling of the neck and suspected of a deep neck abscess was found in computed tomography and magnetic resonance imaging to have no abscess. Infection spread rapidly and CRP rose while platelets and blood pressure decreased leading us to suspect TSLS. Pus culture yielded Streptcoccus pyogenes, Group A. We administered high-dose penicillin, clindamycin, and gabexate mesilate with intensive supporting care, leading to a successful outcome. TSLS is a life-threatening infection, but early diagnosis and appropriate therapy may reverse this threat.
Kawata
Akihiro
A
Division of Otorhinolaryngology, Department of Translational Medical Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki.
Sakihama
Noriyuki
N
Osato
Yasuo
Y
Oku
Ryouta
R
Tanaka
Fujinobu
F
Takahashi
Haruo
H
D002481:Cellulitis / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012772:Shock, Septic / Q000175:diagnosis*; D013290:Streptococcal Infections / Q000175:diagnosis*; D013297:Streptococcus pyogenes