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Toxic shock syndrome secondary to surgery for a discharging ear with chronic otitis media

Published online by Cambridge University Press:  18 October 2021

W Wang
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Peking University People's Hospital, Beijing, China
H Zheng
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Peking University People's Hospital, Beijing, China
L Yu*
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Peking University People's Hospital, Beijing, China
*
Author for correspondence: Dr Lisheng Yu, E-mail: ent_3750@163.com

Abstract

Background

Toxic shock syndrome is an uncommon but lethal infectious disease. To date, toxic shock syndrome related to otological surgical procedures has rarely been reported.

Case report

A 43-year-old man was admitted for surgery for a discharging ear with chronic otitis media. Gelfoam and tela iodoform were used to pack the mastoid cavity. Twelve hours post-operatively, he developed a high fever, dramatic gastrointestinal symptoms, and subsequent shock without local signs of infection or meningeal irritation. Culture of ear discharge grew methicillin-resistant Staphylococcus aureus. A macular rash was noted 2 days post-operatively. The patient received aggressive fluid resuscitation, antibiotics and intensive life-sustaining treatment, and the mastoid cavity was opened to facilitate drainage. However, his condition deteriorated promptly and he died of septic shock. Multiple blood cultures showed negative results.

Conclusion

Clinicians should be vigilant for toxic shock syndrome in patients after surgery for a discharging ear with chronic otitis media, even without local signs of infection.

Information

Type
Clinical Records
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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