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. 2017 Jul 15:10:12-14.
doi: 10.1016/j.idcr.2017.07.004. eCollection 2017.

Toxic shock syndrome caused by suture abscess with methicillin-resistant Staphylococcus aureus (MRSA) with late onset after Caesarean section

Hiroyasu Komuro  1 , Takaharu Kato  1   2 , Shinichiro Okada  1 , Kensuke Nakatani  1 , Risa Matsumoto  1 , Kazuhiro Nishida  1 , Hiroyuki Iida  3 , Maki Iida  4 , Shiro Tsujimoto  4 , Toshiyuki Suganuma  1
Affiliations

Toxic shock syndrome caused by suture abscess with methicillin-resistant Staphylococcus aureus (MRSA) with late onset after Caesarean section

Hiroyasu Komuro et al. IDCases. .

Abstract

Toxic shock syndrome (TSS) is a rare but life-threatening multisystem disease known to develop in the early postoperative period after various surgery. We report a rare case in which a patient who underwent Caesarean section developed TSS caused by methicillin-resistant Staphylococcus aureus (MRSA) on the 39th postoperative day. She was treated with debridement because of the possible diagnosis of necrotizing soft tissue infections. Culture test from the resected specimen was positive for MRSA. She was diagnosed with TSS caused by suture abscess and was treated with intensive care including antimicrobials. After a good postoperative course, she was discharged on the 30th postoperative day. TSS occurring 4 weeks after operation is extremely rare, but late-onset of suture abscess is known to occur. We should becognizant of development with TSS beyond early postoperative period.

Keywords: Caesarean section; Late onset; Methicillin-resistant staphylococcus aureus; Surgical site infection; Toxic shock syndrome.

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Figures

Fig. 1
Fig. 1
The patient had a rash on the trunk of her body and arms, and also subcutaneous bleeding in the area from where the ECG pads had been removed (arrows).
Fig. 2
Fig. 2
Abdominal MRI examination revealed high signal-intensity lesion (arrows) around the surgical scar in T2 weighted images with fat-suppression.
Fig. 3
Fig. 3
Histological analysis of the resected specimen showed that inflammatory cells infiltration under the deep dermis were observed. It showed panniculitis was been there.
See this image and copyright information in PMC

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