A Case of Toxic Shock-like Syndrome Affecting the Neck

Saka Naoki, Seo Toru, Kashiba Keiko, Nishida Takaya

doi:10.3950/jibiinkoka.109.703

Bibliographic Information

Other Title

頸部感染巣より発症した劇症型Ａ群溶連菌感染症の１例
ケイブカンセンソウヨリハッショウシタゲキショウガタ Aグンヨウレンキンカンセンショウノ 1レイ

Search this article

Description

Toxic shock-like syndrome (TSLS) is a form of rapidly progressing septic shock that can lead to multiple organ failure and has a high mortality rate of 30%. We report a rare case of TSLS affecting the head and neck. A 40-year-old man complained of redness and swelling of the neck with vomiting and diarrhea. His blood pressure dropped, and multiple organ failure occurred.<br>Streptcoccus pyogenes, Group A, was identified in a blood culture, and he was diagnosed as having TSLS. He was treated with high-dose carbapenem, clindamysin, and gamma globulin. Continuous hemodiafiltration (CHDF) and PMX-DHP was applied to prevent sepsis and multiple organ failure. Debridement of the neck was performed on day 16. He recovered gradually and was discharged from hospital on day 45. A total resection is required to treat TSLS, but such a procedure is difficult to perform in the head and neck region. Our case improved without resection but after debridement and general control.<br>TSLS should be first treated by medication and then by surgery, consisting of either debridement or resection.

Journal

Nippon Jibiinkoka Gakkai Kaiho

Nippon Jibiinkoka Gakkai Kaiho 109 (9), 703-706, 2006

Japanese Society of Otorhinolaryngology-Head and neck surgery

Keywords

Details 詳細情報について

Export