Fishman G, Ophir D
Head Neck Surgery Dept., Meir Hospital, Kfar Saba.
Harefuah. 1997 May 1;132(9):622-4, 679.
Toxic shock syndrome (TSS) is a rare, life-threatening, acute multisystem illness usually characterized by sudden onset of high fever, diffuse sunburn-like erythroderma and a variety of other signs and symptoms. It may progress rapidly to hypotension and shock with multiple organ failure. Its exact cause is unknown, but in almost all cases there has been an infection with exotoxin-producing strains of phage group I Staphylococcus aureus. Although initially described in association with the use of superabsorbent tampons in menstruation, TSS has complicated a variety of surgical procedures. Recently in head and neck surgery attention has focused on absorbent packing materials, such as those used in postoperative nasal care. TSS developed in a 12-year-old 28 hours after tonsillectomy, nasal septoplasty and inferior turbinectomy in which absorbent packing material was used. It is important to maintain a high index of suspicion for TSS in all postoperative patients with fever, hypotension and erythroderma.
中毒性休克综合征(TSS)是一种罕见的、危及生命的急性多系统疾病,通常表现为突然高热、弥漫性晒伤样红斑及多种其他体征和症状。它可能迅速发展为低血压和休克,并伴有多器官功能衰竭。其确切病因尚不清楚,但几乎在所有病例中,都存在由I组噬菌体金黄色葡萄球菌产外毒素菌株引起的感染。虽然最初是在与月经期间使用高吸收性卫生棉条相关的情况下被描述,但TSS已使多种外科手术变得复杂。最近在头颈外科手术中,关注点集中在吸收性填充材料上,比如用于术后鼻腔护理的材料。一名12岁患儿在扁桃体切除术、鼻中隔成形术和下鼻甲切除术后28小时发生了TSS,术中使用了吸收性填充材料。对于所有术后出现发热、低血压和红斑的患者,保持对TSS的高度怀疑指数很重要。