2010 Volume 13 Issue 1 Pages 63-70
Toxic shock syndrome (TSS) is a serious multisystem disease, first described in 1987 by Todd. We report TSS following segmental mandibulotomy. A57-year-old man underwent this operation following recurrence of tongue cancer. Two days later he had high-grade fever, nausea, vomiting and watery diarrhea. Methicillin-resistant Staphylococcus aureus (MRSA) was observed in a culture from the wound. The infection progressed rapidly to fulminant septic shock with severe hypotension and multiple organ dysfunction. Microbiological examination was positive for toxic shock syndrome toxin-1 (TSST-1). Based on the CDC criteria, our case was diagnosed with high probability as TSS. He was admitted to our intensive care unit and was treated with antibiotics, gamma globulin, and Polymixin B immobilized fiber-direct hemoperfusion (PMX-DHP). By day 57 after surgery he had recovered, and was discharged. TSS is a potentially life-threatening postoperative complication. Considerable suspicion is needed if rapid diagnosis is to be made, and morbidity prevented.
