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The children, a 13-year-old girl and an 11-year-old boy, each spent around 10 days recovering in hospital in separate incidents last year after being admitted with fever, vomiting and diarrhoea.
In both cases their bodies became covered in rashes and the skin peeled from their hands and feet, Birmingham Children's Hospital consultant Mark Taylor and two colleagues reported in the British Medical Journal.
Postoperative toxic shock syndrome (PTSS) after orthopedic surgery is rare, but early recognition and prompt intervention are essential to minimize morbidity and potential mortality. The diagnosis should be considered in all postoperative patients presenting with fever, hypotension, and systemic illness. The treating surgeon must have not only knowledge of the clinical entity, but also an extremely high index of suspicion, because the diagnosis can be elusive with surgical wounds appearing deceptively benign. Treatment consists of antibiotics, surgical wound debridement, and, more importantly, aggressive supportive care with intravenous fluids and intensive care surveillance. To date, the literature contains relatively few case reports of PTSS after orthopedic procedures, with even fewer cases encountered after foot and ankle surgery. This report describes a patient who developed the rare complication of PTSS after an elective ganglion cyst excision from the ankle.
Football Boots and Toxic Shock Syndrome
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