title: [Toxic shock-like syndrome presenting as phlegmon of the neck: a case report].
abstract: 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.
authors.affiliation: Division of Otorhinolaryngology, Department of Translational Medical Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Kawata
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Sakihama
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Osato
authors.forename: Ryouta
authors.initials: R
authors.lastname: Oku
authors.forename: Fujinobu
authors.initials: F
authors.lastname: Tanaka
authors.forename: Haruo
authors.initials: H
authors.lastname: Takahashi
mesh_terms: D002481:Cellulitis / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012772:Shock, Septic / Q000175:diagnosis*; D013290:Streptococcal Infections / Q000175:diagnosis*; D013297:Streptococcus pyogenes