<abstract xmlns="http://www.w3.org/1999/xhtml"><p> Staphylococcal toxic shock syndrome (STSS) is a rare, potentially lethal infection, with a clinical picture of multiple organ dysfunction and shock. The etiology is Staphylococcus aureus exotoxin, while enterotoxins act as superantigens. Most cases are identified in women using a vaginal tampon. A 51-year-old female, with a past medical history of biliary dyskinesia, presented in the emergency room complaining of sudden onset of abdominal pain, vomiting, headache, myalgia, and chills. The initial diagnosis was biliary colic and was treated parenterally with Amoxi-clavulanate and fluid replacement. Initially, progress was unsatisfactory. Four days after admission she developed a systemic inflammatory syndrome, diffuse rash, jaundice, oliguria, confusion, persistent hypotension and biological evidence of thrombocytopenia, nitrogen retention, and cholestasis. She was admitted to the intensive care unit. A gluteal phlegmon induced after intramuscular injections was identified and surgically treated. Blood bacteriological cultures were negative, though MRSA was isolated in phlegmon pus. A diagnosis of STSS was based on CDC criteria.</p><p>The risks of similar infections could be prevented by limiting intramuscular treatments and monitoring invasive procedures.</p></abstract>

Staphylococcal toxic shock syndrome (STSS) is a rare, potentially lethal infection, with a clinical picture of multiple organ dysfunction and shock. The etiology is Staphylococcus aureus exotoxin, while enterotoxins act as superantigens. Most cases are identified in women using a vaginal tampon. A 51-year-old female, with a past medical history of biliary dyskinesia, presented in the emergency room complaining of sudden onset of abdominal pain, vomiting, headache, myalgia, and chills. The initial diagnosis was biliary colic and was treated parenterally with Amoxi-clavulanate and fluid replacement. Initially, progress was unsatisfactory. Four days after admission she developed a systemic inflammatory syndrome, diffuse rash, jaundice, oliguria, confusion, persistent hypotension and biological evidence of thrombocytopenia, nitrogen retention, and cholestasis. She was admitted to the intensive care unit. A gluteal phlegmon induced after intramuscular injections was identified and surgically treated. Blood bacteriological cultures were negative, though MRSA was isolated in phlegmon pus. A diagnosis of STSS was based on CDC criteria.The risks of similar infections could be prevented by limiting intramuscular treatments and monitoring invasive procedures.

Nosocomial Staphylococcal Toxic Shock. Case Report

“Dunarea de Jos” University Galati, Romania

Hospital of Infectious Diseases “Sf. Cuvioasa Parascheva” Galaţi, Romania

The Journal of Critical Care Medicine

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

{"article-title":"Nosocomial Staphylococcal Toxic Shock. Case Report"}

Staphylococcal toxic shock syndrome (STSS) is a rare, potentially lethal infection, with a clinical picture of multiple organ dysfunction and shock. The...

Nosocomial Staphylococcal Toxic Shock. Case Report

Published Online: Aug 10, 2016

Page range: 142 - 144

Received: Apr 04, 2016

Accepted: May 26, 2016

DOI: https://doi.org/10.1515/jccm-2016-0020

Keywords
staphylococcal toxic shock syndrome, MRSA, phlegmon

© 2016

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Nosocomial Staphylococcal Toxic Shock. Case Report

Published Online: Aug 10, 2016

Page range: 142 - 144

Received: Apr 04, 2016

Accepted: May 26, 2016

DOI: https://doi.org/10.1515/jccm-2016-0020

Keywordsstaphylococcal toxic shock syndrome, MRSA, phlegmon

© 2016

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Keywords
staphylococcal toxic shock syndrome, MRSA, phlegmon