A case of streptococcal toxic shock syndrome in the neck region

YAMAMOTO Hiroshi, KOBAYASHI Junji, ICHIJIMA Takehiro, HAYASHI Chikako, FUSE Yuma

doi:10.5794/jjoms.60.286

Streptococcal toxic shock syndrome （STSS） can develop suddenly and cause septic shock, which rapidly progresses to multiple organ failure. The focus of the infection is often observed in the extremities and rarely occurs in the head or neck region. The patient was a 63-year-old woman who was referred to our department by a nearby dental clinic because of swelling beneath the jaw and pain radiating to the submental region. We administered ampicillin and clindamycin phosphate after diagnosing neck phlegmon and performed an abscess incision under general anesthesia. The patient went into shock while under postoperative supervision in the intensive care unit, and liver failure, renal failure, and disseminated intravascular coagulation developed. STSS was diagnosed after group A streptococcus was detected on bacterial culture of exudate taken from regions near the incision that was made during surgery. Antibiotics were administered, and the region of the incision was cleaned. The patient recovered well and was discharged from the hospital on day 39. One year after discharge, the patient is currently under follow-up observation at an outpatient clinic, has had no relapse to date, and is in good condition.

A case of streptococcal toxic shock syndrome in the neck region

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