Abstract
A 33-year-old male underwent the outpatient surgery for an anal fistula in a surgical clinic. High fever (40°C) and severe buttock pain occurred on the second postoperative day, and an antibacterial medicine was administered to him by an internist. However, his buttock pain and physical status gradually got worse, and he was admitted to another hospital on the fifth postoperative day. Despite antibacterial therapy, he developed shock on the same day, and was referred to our hospital. Laboratory data performed on arrival showed disseminated intravascular coagulation and multiple organ failure caused by septic shock. He died about 9 hours after the arrival to our hospital although we provided intensive care to him, including circulatory assist such as intra-aortic balloon pumping and percutaneous cardiopulmonary support to him.
This is the first report of severe toxic streptococcal syndrome following surgery for an anal fistula. It is important to prevent postoperative infection even in a minor operation such as anal fistula.
