• Maxillofacial Plastic and Reconstructive Surgery
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• v.21 no.1
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• pp.69-73
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• 1999

Toxic shock syndrome is an acute disease involving multiple organs. I described here a case of TSS associated with intranasal packing. Four major criteria, which are involvement of multiple organ systems, fever, hypotension or shock, and rash with subsequent desquamation should be fulfilled for the diagnosis. The exact pathogenesis is not well understood, however it is thought to be due to the effects of an enterotoxin produced by certain strains of staphylococcus aureus.

• Clinical and Experimental Pediatrics
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• v.57 no.12
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• pp.538-541
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• 2014

Varicella is usually considered to be a benign disease in healthy children; however, serious complications can occur such as necrotizing fasciitis and toxic shock syndrome. We describe a 38-month-old girl with necrotizing fasciitis and streptococcal toxic shock syndrome following varicella. She was previously healthy and vaccinated against varicella at 12 months of age. She had been diagnosed with varicella three days prior to presenting at our facility; she developed fever, vomiting, and painful swelling on her left flank. Her skin lesions worsened, she became lethargic, and had episodes of hypotension and coagulopathy. Necrotizing fasciitis on the left abdominal wall, buttocks, and left thigh was diagnosed by magnetic resonance imaging, and group A Streptococcus was isolated from a tissue culture. She was diagnosed as necrotizing fasciitis and streptococcal toxic shock syndrome, and successfully treated with repeated surgical debridement and fasciotomy, in addition to intensive antibiotics. Our experience suggests that necrotizing fasciitis in patients with varicella should be considered to be a rare complication even with widespread vaccine use. Early diagnosis and intensive treatment are required to prevent a fatal outcome.

• Pediatric Infection and Vaccine
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• v.3 no.1
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• pp.88-93
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• 1996

A군 연쇄구균에 의한 독성 쇼크 증후군은 기저질환이 없는 젊은 사람에서 쇼크와 다장기 부전증을 일으키는 신종 질환이다. 이 질환은 진행이 매우 빠르고 치명적이기 때문에 신속한 진단과 항균제 투여, 괴사조직의 수술적 제거가 필요하고 수액 주입 혹은 심근 강화제 등으로 쇼크를 적극적으로 치료를 해야 한다. 11세 여자 환아가 쇼크 목 부위 연조직 괴사, 급성 호흡부전, 신부전 및 패혈증으로 사망하여, 연쇄구균성 독성 쇼크 증후군(streptococcal toxic shock syndrome)으로 진단 받았기에 보고하는 바이다.

• Pediatric Infection and Vaccine
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• v.16 no.2
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• pp.205-209
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• 2009

Staphylococcal toxic shock syndrome (TSS) is a severe systemic illness caused by toxins produced by Staphylococcus aureus. We report a case of staphylococcal TSS in a 16 month-old boy who presented with high fever, vomiting, skin rash, and shock after a burn injury. He was managed with intravenous vancomycin, fresh frozen plasma, and intravenous immunoglobulin. Methicillin-resistant S. aureus (MRSA) was isolated from the burn wound site and anterior nostril of the patient. In addition, the MRSA isolate was genetically characterized.

• Pediatric Infection and Vaccine
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• v.8 no.1
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• pp.114-117
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• 2001

We experienced a case of streptococcal toxic shock-like sundrome in a 12 year old boy. Symptoms such as fever, sore throat, diffuse erythematous rashes on whole body developed 3 days before admmision. His symptoms rapidly aggravated to develop hypotension, hepatic and renal dysfunction and thrombocytopenia. After admission, intravenous fluid and antibiotic therapy were done and he was succesfully treated. Attention should be paid to recognize and diagnose this fatal disese. We report this case with review of related literatures.

• Pediatric Infection and Vaccine
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• v.4 no.1
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• pp.160-166
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• 1997

Toxic shock syndrome(TSS) is a multisystemic disease presenting with high fever, sunburn like rash that subsequently desquamates, and hypotension mainly caused by toxin producing strains of Staphylococcus aureus. It was first reported in 1978 by Todd et al, thereafter many patients have been reported. In children, TSS is rare and must be differentiated from other erythematous febrile diseases such as Kawasaki disease, scarlet fever, drug eruption etc. We experienced a case of TSS associated with staphylococcal cellulitis in 26-month old boy, who was presenting similar symptoms to Kawasaki disease at initial stage of illness. As time passed, the patient represented more typical symptoms of TSS and Staphylococcus aureus was isolated from cellulitis of the right elbow area. Therefore, we report this case with a brief review of related literatures.

• Clinical and Experimental Pediatrics
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• v.45 no.8
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• pp.1048-1051
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• 2002

Toxic shock syndrome(TSS) is clinically similar to Kawasaki disease(KD) in that both of them are characterized by fever, desquamating rash and mucous membrane erythema. In contrast the main feature of TSS is hypotension, whereas the complication of KD is coronary vasculitis. We report an 8-year-old boy who fulfilled the crireria for TSS and KD. Initially he showed clinical features of TSS, so he was treated with intravenous antibiotics and supportive management. But the fever sustained, and the coronary aneurysm that is the main complication of Kawasaki disease was shown by echocardiogram on Day 14. He was treated with intravenous immunoglobulin twice and the fever subsided and general condition was improved.

• Journal of Life Science
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• v.6 no.2
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• pp.111-119
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• 1996

The production of interleukin-1(IL-1)and nitric oxide(NO) by cultured fibroblast cells of human nasal turbinate was revealed by biological assay respectively. The cells were incubated for various periods of time in the presence of staphyloccocal toxic shock syndrome toxin-1(TSST-1) and house dust mite(Dermatophagoides farinae, HDM), and the culture supernatants were harvested. There was a little difference in the activities of IL-1beta and the amount of NO produced by the cells when stimulated with 0.002-0.1$\mu$g/ml of TSSTO-1 and 0.02-1$\mu$g/ml of HDM. The shapes of the time course curves for the production of IL-1beta and NO by the cells were different. Groups stimulated with TSST-1 or HDM produced more IL-beta in 2 h than no exposure group(Control). A certain mixed group(TSST-1, 10ng+mite, 100 ng) continued to produce IL-1beta highly throughout the entire incubation period. The cells stimulated with TSST-1 or HDM produced more NO in 2 h and 6 h than that produced in the end of incubation(48 h). Also, the mixed groups were generally similar. There results suggest that induction of IL-1beta by a certain mixed condition(TSST-1+mite) in fibroblast cell in vivo may play a role in inflammation.

• Archives of Plastic Surgery
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• v.48 no.2
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• pp.189-193
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• 2021

Breast implant insertion is one of the most commonly used methods for breast reconstruction after total mastectomy. However, infection is a common postoperative complication of implant insertion. In most cases, these infections can be managed with antibiotics and supportive therapy. However, severe septic conditions, such as toxic shock syndrome (TSS), can sometimes occur. TSS is an extremely rare but life-threatening complication, for which early diagnosis and proper management play a crucial role in determining patients' outcome. Although only 16 cases of TSS after breast implant insertion have been reported in the literature, most of those cases involved a serious clinical course. The reason for the seriousness of the clinical course of TSS in these cases is that the initial impression and presentation of these patients are nonspecific, and patients can easily be misdiagnosed as having a simple upper respiratory infection, causing the underlying condition to be neglected. Herein, we present two patients who were diagnosed with TSS after receiving breast reconstruction surgery via a silicone implant after total mastectomy. Both patients were misdiagnosed at the initial examination since they showed no local infectious signs on the postoperative wound.

• Journal of Yeungnam Medical Science
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• v.3 no.1
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• pp.25-31
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• 1986