Abstract
Toxic shock syndrome (TSS) is characterized by symptoms such as sudden high fever, systemic diffuse erythema, decreased blood pressure, and multiorgan impairment. TSS is caused by toxins produced by Staphylococcus aureus. In serious cases, this condition may result in death. This report describes a case of TSS after mastectomy.
A 47-year-old woman who had undergone mastectomy with sentinel-lymphnode biopsy for breast cancer of the right breast developed TSS. She experienced fever, vomiting, and diarrhea since postoperative day 2 and systemic diffuse erythema, sore throat, congestion of the tongue, and decreased blood pressure since postoperative day 3. On the basis of these findings, we suspected TSS. The patient was administered sufficient fluid infusion and antibiotics, and the surgical wound discharge was cultivated. The culture analysis revealed infection of Staphylococcus aureus that had produced toxic shock syndrome toxin-1, and TSS was diagnosed. In the course of treatment, she showed multiorgan impairment (liver and kidney) and decrease in platelet level, but her symtoms improved in about 10 days.
When postsurgical patients develop symptoms such as fever, systemic eryhtema, and shock TSS should be suspected and appropriate treatment should be initiated promptly.
