Early Diagnosis of Toxic Shock like Syndrome by Magnetic Resonance Imaging and Histopathology
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- Kubota Nobuhiko
- Department of Acute and Critical Care Medicine, Hokkaido University Hospital
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- Matsuda Naoyuki
- Department of Acute and Critical Care Medicine, Hokkaido University Hospital
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- Tikai Kanako
- Department of Surgical Pathology, Hokkaido University Hospital
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- Ito Tomoo
- Department of Surgical Pathology, Hokkaido University Hospital
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- Chiba Hitoshi
- Department of Infection Control Service, Hokkaido University Hospital
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- Kameue Takashi
- Department of Acute and Critical Care Medicine, Hokkaido University Hospital
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- Gando Satoshi
- Department of Acute and Critical Care Medicine, Hokkaido University Hospital
Bibliographic Information
- Other Title
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- 劇症型A群β溶連菌感染症の救命にMRIと術中迅速病理診断を用いた1症例
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Description
A 33-year-old man was admitted to our emergency room with tachycardia and hypotension. Diffuse swelling, extensive blistering were noted in the body region extending from the left thigh to the left scrotum. Laboratory data revealed severe metabolic acidosis with an elevated anion gap and high lactate level, leukocytosis and renal dysfunction. Bacteriological examination of the exudate obtained from the blisters revealed numerous Gram-positive cocci. Although computed tomography revealed only swelling of the left thigh and scrotum, MRI, which was performed when the patient was clinically stable at the previous hospital, clearly suggested extensive myofascitis of the left thigh. An emergency debridement of the infected wounds was carried out, and intraoperative histopathological diagnosis guided the area of debridment. The resected tissues from the left thigh and scrotum revealed widespread necrosis and large numbers of Gram-positive cocci, which were identified as Group A β-hemolytic streptococci. In this case report, we show that MRI and intraoperative histopathological examination are more effective than computed tomography for the early diagnosis of TSLS.
Journal
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- Nihon Kyukyu Igakukai Zasshi
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Nihon Kyukyu Igakukai Zasshi 15 (10), 563-568, 2004
Japanese Association for Acute Medicine
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Keywords
Details 詳細情報について
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- CRID
- 1390001204370265984
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- NII Article ID
- 130003625947
- 10014257818
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- NII Book ID
- AN10284604
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- ISSN
- 18833772
- 0915924X
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- Text Lang
- ja
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- Data Source
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- JaLC
- Crossref
- CiNii Articles
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- Abstract License Flag
- Disallowed