扩张器植入式乳房重建术后耐甲氧西林金黄色葡萄球菌（MRSA）引起的中毒性休克综合征
Toxic Shock Syndrome Caused by Methicillin-Resistant Staphylococcus aureus (MRSA) After Expander-Based Breast Reconstruction.
作者信息
Suga Hirotaka, Shiraishi Tomohiro, Takushima Akihiko, Harii Kiyonori
机构信息
Department of Plastic Surgery, Kyorin University School of Medicine, Tokyo, Japan.
出版信息
Eplasty. 2016 Jan 8;16:e2. eCollection 2016.
OBJECTIVE
Toxic shock syndrome is a rare but life-threatening complication after plastic surgery procedures.
METHODS
We experienced 2 cases of toxic shock syndrome after expander-based breast reconstruction caused by methicillin-resistant Staphylococcus aureus.
RESULTS
The first patient took a severe clinical course due to the delayed diagnosis and treatment, and the second patient recovered rapidly after the early diagnosis and treatment based on our experience of the first case. Fever, rash, and gastrointestinal symptoms (diarrhea and/or vomiting) were characteristic and important for the early diagnosis of toxic shock syndrome.
CONCLUSIONS
Considering the increased prevalence of methicillin-resistant Staphylococcus aureus, we should suspect methicillin-resistant Staphylococcus aureus in cases of toxic shock syndrome that occur postoperatively, and the empiric administration of vancomycin should be initiated in such cases.
目的
中毒性休克综合征是整形手术后一种罕见但危及生命的并发症。
方法
我们遇到2例由耐甲氧西林金黄色葡萄球菌引起的基于扩张器的乳房重建术后中毒性休克综合征病例。
结果
首例患者因诊断和治疗延迟而经历了严重的临床过程，第二例患者基于我们对首例病例的经验在早期诊断和治疗后迅速康复。发热、皮疹和胃肠道症状（腹泻和/或呕吐）是中毒性休克综合征早期诊断的特征且很重要。
结论
考虑到耐甲氧西林金黄色葡萄球菌的患病率增加，对于术后发生的中毒性休克综合征病例，我们应怀疑耐甲氧西林金黄色葡萄球菌，并且在此类病例中应开始经验性使用万古霉素。
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