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Staphylococcal toxic shock syndrome in a paediatric burn unit
E A Bacha1, R L Sheridan, G A Donohue
1Massachusetts General Hospital, Department of Surgery, Harvard Medical School, Boston.
Burns : Journal of the International Society for Burn Injuries
|December 1, 1994
Summary
Staphylococcal toxic shock syndrome (TSS) can occur after surgery, not just in menstruating women. Caution with occlusive dressings and isolating patients with specific Staph. aureus strains are advised for postsurgical TSS prevention.
Area of Science:
- Infectious Diseases
- Surgical Complications
- Microbiology
Background:
- Toxic Shock Syndrome (TSS) is a severe illness typically associated with menstruating women using tampons.
- Non-menstrual TSS, including postsurgical cases, is less common but recognized.
- Staphylococcus aureus, particularly strains producing TSST-1, is the primary causative agent.
Observation:
- A case of staphylococcal TSS in a 15-year-old patient following reconstructive burn surgery is presented.
- The patient's presentation, microbiology, and treatment are detailed.
- The occurrence of TSS in a postsurgical context highlights its broader etiology.
Findings:
- The case demonstrates that TSS can be a complication of reconstructive surgery, even in pediatric patients.
- Epidemiology, microbiology, and clinical presentation of non-menstrual TSS are discussed.
- Management strategies for postsurgical TSS are considered.
Implications:
- Caution is advised regarding the use of occlusive dressings in patients with open wounds.
- Constant isolation of patients colonized with TSST-1 producing Staphylococcus aureus is recommended to prevent TSS.
- This case underscores the importance of recognizing and managing non-menstrual TSS in surgical settings.