When All Else Fails: A Rare Case of Postoperative Toxic Shock Syndrome Arising from Surgical Site Infection after Decompressive Neurectomy Successfully Treated with Angiotensin-2

Author:

Chandra Raghav1ORCID,Gold Samuel1ORCID,Kohler Casey2ORCID,Valladares Jason3ORCID,Hennessy Sara A.2ORCID,Bhat Sneha G.2ORCID

Affiliation:

1. Department of Surgery, University of Texas, Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA

2. Division of Burns, Trauma, Acute, and Critical Care Surgery, Department of Surgery, University of Texas, Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA

3. Department of Anesthesia, University of Texas, Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA

Abstract

Toxic shock syndrome is a serious complication of Streptococcus pyogenes or Staphylococcus aureus infections associated with very high morbidity and mortality. Postoperative toxic shock syndrome is an extremely rare phenomenon which manifests as fevers, diffuse rash, septic shock, and death. We present the first reported case of toxic shock syndrome associated with a surgical site infection from a decompressive neurectomy for refractory migraines in a 41-year-old female as well as the first use of angiotensin-2 vasopressor therapy to treat persistent septic shock from toxic shock syndrome refractory to conventional therapies.

Publisher

Hindawi Limited

Subject

Critical Care and Intensive Care Medicine

Reference10 articles.

1. Postoperative Toxic Shock Syndrome

2. Streptococcal Superantigens: biological properties and potential role in disease;T. Proft

3. Streptococcal toxic shock syndrome in the intensive care unit

4. Toxic shock syndrome associated with surgical wound infections;P. Bartlett;Journal of the American Medical Association,1982

5. Invasive Group A Streptococcal Infections in Ontario, Canada

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