急性虫垂炎手術後にメチシリン耐性ブドウ球菌腹膜炎を発症し, toxic shock syndromeに至った1例

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  • A CASE OF TOXIC SHOCK SYNDROME CAUSED BY METHICILLIN RESISTANT STAPHYLOCOCCUS AUREUS AFTER APPENDECTOMY

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Staphylococcus causing toxic shock syndrome (TSS) in the surgical field is Methicillin-resistant Staphylococus aureus (MRSA) in most cases. Postoperative MRSA is an important factor to provoke TSS. Postoperative MRSA infection has been speculated mostly as a result of the prophylactic use of third-generation cephems on the immunologically compromised patient. However, the virulence of the bacteria may possibly overpower the defence mechanism of the host who has undergone minimum surgical stress. Recently we experienced an adult male patient with non-perforated acute appendicitis who developed MRSA peritonitis after an appendectomy causing TSS in an acute clinical course. We have reconfirmed that even patient without any risk factors can develop MRSA infection followed by TSS, if things come to the worst. The importance of the careful monitoring and management of postoperative MRSA infection even after the less invasive abdominal surgery should be emphasized.

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