MRSA toxic shock syndrome associated with surgery for left leg fracture and co-morbid compartment syndrome

We report the case of a 46 year old Japanese man who was brought to the hospital with fever, hypotension and diffuse erythematous rash with multiple organ damage. Three weeks before he had undergone orthopaedic surgery for left leg fracture and comorbid compartment syndrome. Lasciorrhaphy was performed successfully 2 weeks before, but the next day he became feverish and hypotensive with signs of systemic low perfusion. He was referred to the hospital for further evaluation and treatment. On arrival, high fever, hypotension and diffuse erythroderma were observed. Lab results revealed multi organ dysfunction. Clinical manifestations led to the diagnosis of toxic shock syndrome (ass). The patient was treated with extensive hydration, local drainage and antibiotics. After 2 weeks of intensive care, he recovered and was successfully discharged from the hospital. A culture of the wound tissue revealed the presence of MRSA with positive TSST-1.