[Probable toxic shock syndrome following pleural drainage]

Toxic shock syndrome (TSS) is rare complication after minor surgical procedure. A 22-year-old man was admitted our hospital with spontaneous pneumothorax on the right side. Few days after pleural drainage, he developed a high fever often over 40 degrees C and a rash, most demonstrating a truncal, "sunburn" pattern. Initially, he was diagnosed as right pylothorax, but the clinical course was not typical and antibiotic treatment was not effective. Two weeks later, desquamation of the hands and feet were noted, and methicillin-resistant Staphylococcus aureus (MRSA) isolated from the pleural effusion were identified as TSS toxin (TSST)-1 and enterotoxin-C producing. He was diagnosed as probable TSS, and recovered by steroid therapy. Early awareness and recognition of this disease is necessary for surgeons.