Toxic shock syndrome following functional endonasal sinus surgery: a case report

Toxic shock syndrome (TSS) is a serious multisystem disease that was first described in 1978 by Todd. It occurs most often in menstruating women using superabsorbent tampons. The exact pathogenesis is not well understood, but it is felt to be due to the effects of an enterotoxin produced by certain strains of Staphylococcus aureus. The reported incidence of TSS following nasal surgery is 16/100,000. We report a case of TSS following endonasal sinus surgery in which minimal packing was used. The nasal surgeon should be aware of this rare and possibly fatal entity, as TSS may occur following any nasal/sinus surgery, even where packing is minimal and of short duration and when the patient is receiving antibiotic therapy.