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Postoperative toxic shock syndrome
M G Raab1, M O'Brien, J M Hayes
1Dwight D. Eisenhower Army Medical Center, Fort Gordon, Georgia, USA.
American Journal of Orthopedics (Belle Mead, N.J.)
|February 1, 1995
Summary
Postoperative toxic shock syndrome (PTSS) is rare, but early recognition is crucial. This study found no specific risk factors, emphasizing vigilance for acutely ill patients with fever, even with minor wound appearances.
Area of Science:
- Infectious Diseases
- Surgical Complications
- Toxicology
Background:
- Postoperative toxic shock syndrome (PTSS) is a rare, severe complication of surgical wound infections.
- PTSS presents with fever, rash, hypotension, and multisystem organ dysfunction, posing a significant mortality risk.
Purpose of the Study:
- To identify risk factors associated with the development of postoperative toxic shock syndrome (PTSS).
- To understand the clinical presentation and outcomes of PTSS following surgical procedures.
Main Methods:
- A retrospective review of 390,000 surgical procedures across two community hospitals from 1981 to 1993.
- Analysis of 12 identified cases of PTSS to determine potential contributing factors and clinical characteristics.
Main Results:
- Twelve cases of PTSS were identified, representing a 0.003% incidence.
- Staphylococcus aureus was consistently isolated from wound cultures; all isolates were antibiotic-susceptible.
- No correlation was found between PTSS and patient demographics, preoperative care, or surgical procedure details.
Conclusions:
- Early recognition and prompt treatment of PTSS are critical for patient survival.
- No specific risk factors for PTSS were identified in this study.
- PTSS should be considered in postoperative patients presenting with acute fever and systemic illness, irrespective of wound appearance.