Streptococcal toxic shock syndrome after hemorrhoidectomy: A case report  

作　　者：Chien-Yu Lee Yuarn-Jang Lee Chia-Che Chen Li-Jen Kuo 

机构地区：[1]Department of Pediatrics,Taoyuan General Hospital,Ministry of Health and Welfare,Taoyuan 32748,Taiwan [2]Division of Infectious Diseases,Department of Internal Medicine,Taipei Medical University Hospital,Taipei 11031,Taiwan [3]Division of Infectious Diseases,Department of Internal Medicine,School of Medicine,College of Medicine,Taipei Medical University,Taipei 11031,Taiwan [4]Division of Colorectal Surgery,Department of Surgery,Taipei Medical University Hospital,Taipei 11031,Taiwan [5]Department of Surgery,School of Medicine,College of Medicine,Taipei Medical University,Taipei 11031,Taiwan

出　　处：《World Journal of Clinical Cases》2021年第33期10238-10243,共6页世界临床病例杂志

摘　　要：BACKGROUND Streptococcal toxic-shock syndrome after hemorrhoidectomy is rare but may be catastrophic.Group A streptococci have produced various surface proteins and exotoxins due to genetic changes to fight the human body’s immune response.Though life threatening infection after hemorrhoidectomy rarely occurs,all surgeons should be aware of the potential complications of severe sepsis after hemorrhoidectomy and keep in mind their clinical presenting features in order to diagnose early and administer appropriate and effective therapeutic drugs early.CASE SUMMARY Here,we present a case of a 56-year-old man with a painful thrombotic external hemorrhoid who presented to our outpatient department for management.There was no history of systemic diseases or recent disease infection.Hemorrhoidectomy was suggested and performed.After surgery,the patient developed hypotension,tachycardia,fever with chills and renal function impairment on day 2 post-operation.The clinical condition progressed to severe septic shock and metabolic acidosis.The patient responded poorly to treatment and expired after 1 d even with use of extracorporeal membrane oxygenation.The results of the blood and wound cultures showed group A streptococcus pyogenes.CONCLUSION Although extremely uncommon,all surgeons should be aware of these potential life-threatening septic complications and alert to the presenting features for patients receiving hemorrhoidectomy.

关 键 词：HEMORRHOID SEPSIS Streptococcus pyogenes Streptococcal toxic shock syndrome Case report 

分 类 号：R459.7[医药卫生—急诊医学] R657.18[医药卫生—治疗学]