Postoperative Toxic Shock Syndrome
We conducted a retrospective review of all cases of postoperative toxic shock syndrome (PTSS) occurring in two community hospitals from 1981–1993, during which time 390,000 surgical procedures were performed. The incidence was 0.003% (12 cases). All wounds in these 12 cases, from those with scant su...
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| Veröffentlicht in: | Clinical infectious diseases 1995-04, Vol.20 (4), p.895-899 |
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| creator | Graham, Donald R. O'Brien, Maureen Hayes, James M. Raab, Michael G. |
| description | We conducted a retrospective review of all cases of postoperative toxic shock syndrome (PTSS) occurring in two community hospitals from 1981–1993, during which time 390,000 surgical procedures were performed. The incidence was 0.003% (12 cases). All wounds in these 12 cases, from those with scant superficial exudates to those with gross purulence, yielded Staphylococcus aureus. All tested isolates were susceptible to methicillin or cephalothin. Patients had a mean maximal temperature of 40°C. All patients had a rash, most in a truncal, “sunburn” pattern. Eleven patients had desquamation. Mean time from surgery to onset of symptoms was 4 days. All patients required vigorous fluid resuscitation. No correlation could be demonstrated between the development of toxic shock syndrome and a patient's age, sex, preoperative skin preparation or administration of antibiotics, members of the surgical team, or duration of procedure. All patients with PTSS survived. PTSS should be considered in the differential diagnosis for the acutely febrile, systemically ill postoperative patient, even when surgical wounds are deceptively benign in appearance. Early recognition and treatment of PTSS is essential for successful outcome. |
| doi_str_mv | 10.1093/clinids/20.4.895 |
| format | Article |
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The incidence was 0.003% (12 cases). All wounds in these 12 cases, from those with scant superficial exudates to those with gross purulence, yielded Staphylococcus aureus. All tested isolates were susceptible to methicillin or cephalothin. Patients had a mean maximal temperature of 40°C. All patients had a rash, most in a truncal, “sunburn” pattern. Eleven patients had desquamation. Mean time from surgery to onset of symptoms was 4 days. All patients required vigorous fluid resuscitation. No correlation could be demonstrated between the development of toxic shock syndrome and a patient's age, sex, preoperative skin preparation or administration of antibiotics, members of the surgical team, or duration of procedure. All patients with PTSS survived. PTSS should be considered in the differential diagnosis for the acutely febrile, systemically ill postoperative patient, even when surgical wounds are deceptively benign in appearance. Early recognition and treatment of PTSS is essential for successful outcome.</description><identifier>ISSN: 1058-4838</identifier><identifier>EISSN: 1537-6591</identifier><identifier>DOI: 10.1093/clinids/20.4.895</identifier><identifier>PMID: 7795091</identifier><identifier>CODEN: CIDIEL</identifier><language>eng</language><publisher>Chicago, IL: The University of Chicago Press</publisher><subject>Adolescent ; Adult ; Aged ; Antibodies ; Biological and medical sciences ; Clinical Articles ; Enterotoxins ; Exanthema ; Female ; Humans ; Male ; Medical sciences ; Menstrual hygiene products ; Middle Aged ; Notifiable diseases ; Post traumatic stress disorder ; Postoperative Complications - epidemiology ; Postoperative Complications - therapy ; Retrospective Studies ; Shock, Septic - epidemiology ; Shock, Septic - therapy ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgical procedures ; Surgical shock ; Symptoms ; Technology. Biomaterials. Equipments ; Toxicity</subject><ispartof>Clinical infectious diseases, 1995-04, Vol.20 (4), p.895-899</ispartof><rights>Copyright 1995 The University of Chicago</rights><rights>1995 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c413t-6b7da56c9205119d0c2a8c6471b9ca26191d4d0c673746e80a0096c42ba468f73</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.jstor.org/stable/pdf/4458455$$EPDF$$P50$$Gjstor$$H</linktopdf><linktohtml>$$Uhttps://www.jstor.org/stable/4458455$$EHTML$$P50$$Gjstor$$H</linktohtml><link.rule.ids>314,776,780,799,27901,27902,57992,58225</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=3494341$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/7795091$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Graham, Donald R.</creatorcontrib><creatorcontrib>O'Brien, Maureen</creatorcontrib><creatorcontrib>Hayes, James M.</creatorcontrib><creatorcontrib>Raab, Michael G.</creatorcontrib><title>Postoperative Toxic Shock Syndrome</title><title>Clinical infectious diseases</title><addtitle>Clinical Infectious Diseases</addtitle><description>We conducted a retrospective review of all cases of postoperative toxic shock syndrome (PTSS) occurring in two community hospitals from 1981–1993, during which time 390,000 surgical procedures were performed. The incidence was 0.003% (12 cases). All wounds in these 12 cases, from those with scant superficial exudates to those with gross purulence, yielded Staphylococcus aureus. All tested isolates were susceptible to methicillin or cephalothin. Patients had a mean maximal temperature of 40°C. All patients had a rash, most in a truncal, “sunburn” pattern. Eleven patients had desquamation. Mean time from surgery to onset of symptoms was 4 days. All patients required vigorous fluid resuscitation. No correlation could be demonstrated between the development of toxic shock syndrome and a patient's age, sex, preoperative skin preparation or administration of antibiotics, members of the surgical team, or duration of procedure. All patients with PTSS survived. PTSS should be considered in the differential diagnosis for the acutely febrile, systemically ill postoperative patient, even when surgical wounds are deceptively benign in appearance. Early recognition and treatment of PTSS is essential for successful outcome.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Antibodies</subject><subject>Biological and medical sciences</subject><subject>Clinical Articles</subject><subject>Enterotoxins</subject><subject>Exanthema</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Menstrual hygiene products</subject><subject>Middle Aged</subject><subject>Notifiable diseases</subject><subject>Post traumatic stress disorder</subject><subject>Postoperative Complications - epidemiology</subject><subject>Postoperative Complications - therapy</subject><subject>Retrospective Studies</subject><subject>Shock, Septic - epidemiology</subject><subject>Shock, Septic - therapy</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgical procedures</subject><subject>Surgical shock</subject><subject>Symptoms</subject><subject>Technology. Biomaterials. Equipments</subject><subject>Toxicity</subject><issn>1058-4838</issn><issn>1537-6591</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1995</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo9kE1Lw0AQhhdRaq3ePSgUEW9pZ7PfRy3WCAWLrSBels1mg6lpU3dTaf-9KQ09zTLPO7PMg9A1hgEGRYa2LFZFFoYxDOhAKnaCupgREXGm8GnzBiYjKok8RxchLAAwlsA6qCOEYqBwF91Nq1BXa-dNXfy5_rzaFrY_-67sT3-2W2W-WrpLdJabMrirtvbQx_h5PkqiydvL6-hxElmKSR3xVGSGcatiYBirDGxspOVU4FRZE3OscEabLhdEUO4kGADFLY1TQ7nMBemhh8Peta9-Ny7UelkE68rSrFy1CRoLwDE01_QQHILWVyF4l-u1L5bG7zQGvdeiWy06Bk11o6UZuW13b9Kly44DrYeG37fcBGvK3JuVLcIxRqiihO5jN4fYopHmj5hSJinb_xIdcBFqtz1i43_0_mqmk88v_ZQkYzKecv1O_gHWJILB</recordid><startdate>19950401</startdate><enddate>19950401</enddate><creator>Graham, Donald R.</creator><creator>O'Brien, Maureen</creator><creator>Hayes, James M.</creator><creator>Raab, Michael G.</creator><general>The University of Chicago Press</general><general>University of Chicago Press</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QL</scope><scope>7U7</scope><scope>C1K</scope></search><sort><creationdate>19950401</creationdate><title>Postoperative Toxic Shock Syndrome</title><author>Graham, Donald R. ; O'Brien, Maureen ; Hayes, James M. ; Raab, Michael G.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c413t-6b7da56c9205119d0c2a8c6471b9ca26191d4d0c673746e80a0096c42ba468f73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1995</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Antibodies</topic><topic>Biological and medical sciences</topic><topic>Clinical Articles</topic><topic>Enterotoxins</topic><topic>Exanthema</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Menstrual hygiene products</topic><topic>Middle Aged</topic><topic>Notifiable diseases</topic><topic>Post traumatic stress disorder</topic><topic>Postoperative Complications - epidemiology</topic><topic>Postoperative Complications - therapy</topic><topic>Retrospective Studies</topic><topic>Shock, Septic - epidemiology</topic><topic>Shock, Septic - therapy</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgical procedures</topic><topic>Surgical shock</topic><topic>Symptoms</topic><topic>Technology. Biomaterials. Equipments</topic><topic>Toxicity</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Graham, Donald R.</creatorcontrib><creatorcontrib>O'Brien, Maureen</creatorcontrib><creatorcontrib>Hayes, James M.</creatorcontrib><creatorcontrib>Raab, Michael G.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><jtitle>Clinical infectious diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Graham, Donald R.</au><au>O'Brien, Maureen</au><au>Hayes, James M.</au><au>Raab, Michael G.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Postoperative Toxic Shock Syndrome</atitle><jtitle>Clinical infectious diseases</jtitle><addtitle>Clinical Infectious Diseases</addtitle><date>1995-04-01</date><risdate>1995</risdate><volume>20</volume><issue>4</issue><spage>895</spage><epage>899</epage><pages>895-899</pages><issn>1058-4838</issn><eissn>1537-6591</eissn><coden>CIDIEL</coden><abstract>We conducted a retrospective review of all cases of postoperative toxic shock syndrome (PTSS) occurring in two community hospitals from 1981–1993, during which time 390,000 surgical procedures were performed. The incidence was 0.003% (12 cases). All wounds in these 12 cases, from those with scant superficial exudates to those with gross purulence, yielded Staphylococcus aureus. All tested isolates were susceptible to methicillin or cephalothin. Patients had a mean maximal temperature of 40°C. All patients had a rash, most in a truncal, “sunburn” pattern. Eleven patients had desquamation. Mean time from surgery to onset of symptoms was 4 days. All patients required vigorous fluid resuscitation. No correlation could be demonstrated between the development of toxic shock syndrome and a patient's age, sex, preoperative skin preparation or administration of antibiotics, members of the surgical team, or duration of procedure. All patients with PTSS survived. PTSS should be considered in the differential diagnosis for the acutely febrile, systemically ill postoperative patient, even when surgical wounds are deceptively benign in appearance. Early recognition and treatment of PTSS is essential for successful outcome.</abstract><cop>Chicago, IL</cop><pub>The University of Chicago Press</pub><pmid>7795091</pmid><doi>10.1093/clinids/20.4.895</doi><tpages>5</tpages></addata></record> |
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| subjects | Adolescent Adult Aged Antibodies Biological and medical sciences Clinical Articles Enterotoxins Exanthema Female Humans Male Medical sciences Menstrual hygiene products Middle Aged Notifiable diseases Post traumatic stress disorder Postoperative Complications - epidemiology Postoperative Complications - therapy Retrospective Studies Shock, Septic - epidemiology Shock, Septic - therapy Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgical procedures Surgical shock Symptoms Technology. Biomaterials. Equipments Toxicity |
| title | Postoperative Toxic Shock Syndrome |
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