title: Toxic shock syndrome caused by hospital-acquired methicillin-resistant Staphylococcus aureus in a patient with pancytopenia.
abstract: Toxic shock syndrome is an uncommon condition in patients with neutropenia. We describe a 44-year-old man who developed toxic shock syndrome caused by hospitalacquired methicillin-resistant Staphylococcus aureus while pancytopenic after chemotherapy. He died of multiorgan failure despite high-level intensive care support and treatment with appropriate antibiotics and intravenous immunoglobulin. This case illustrates the need for a high index of suspicion for toxic shock syndrome in patients with febrile neutropenia, and also highlights the lack of highquality evidence for the various treatment modalities used in this syndrome.
authors.affiliation: Department of Intensive Care Medicine, Liverpool Hospital, Sydney, NSW.
authors.forename: Benoj
authors.initials: B
authors.lastname: Varghese
authors.forename: Ritesh
authors.initials: R
authors.lastname: Sanghavi
authors.forename: Amjed
authors.initials: A
authors.lastname: Aziz
authors.forename: Iain B
authors.initials: IB
authors.lastname: Gosbell
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects; D003428:Cross Infection / Q000188:drug therapy / Q000382:microbiology*; D003561:Cytarabine / Q000008:administration & dosage / Q000009:adverse effects; D005047:Etoposide / Q000008:administration & dosage / Q000009:adverse effects; D017809:Fatal Outcome; D006801:Humans; D015255:Idarubicin / Q000008:administration & dosage / Q000009:adverse effects; D015470:Leukemia, Myeloid, Acute / Q000150:complications / Q000188:drug therapy; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus; D009102:Multiple Organ Failure; D010198:Pancytopenia / Q000139:chemically induced / Q000276:immunology; D012772:Shock, Septic / Q000188:drug therapy / Q000382:microbiology*; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000382:microbiology*
chemical_list: D000900:Anti-Bacterial Agents; D003561:Cytarabine; D005047:Etoposide; D015255:Idarubicin