Toxic shock syndrome after nasal surgery. Case reports and analysis of risk factors

Toxic shock syndrome (TSS) occurs most often in menstruating women who use tampons. It also occurs following surgical procedures. The occurrence of three cases after nasal surgery prompted us to determine the incidence of this complication and to evaluate possible risk factors. Our cases showed that onset of TSS after surgery is rapid. Early symptoms include nausea, vomiting, diarrhea, erythroderma, and hypotension. The wound does not appear grossly infected. Incidence of TSS after nasal surgery during 1980 through 1983 was 16.5 per 100,000, higher than the incidence in women of menstrual age. Splints were used more frequently in patients who developed TSS than in patients who did not. Nasal packing was used in all patients with TSS and in 98% of all patients. Topical or systemic antibiotics did not have a demonstrable protective effect.