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Toxic-shock-Syndrom nach offener Sprunggelenkverletzung

Toxic shock syndrome after open ankle fracture

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Zusammenfassung

Die Behandlung offener Frakturen stellt eine Herausforderung für den behandelnden Chirurgen dar. Je nach Schweregrad der Verletzung steigt das Infektionsrisiko bis auf 50 %. Trotz chirurgischer und antibiotischer Therapie können lokale Infekte bis hin zur Sepsis entstehen. In dem hier vorgestellten Fall erlitt ein 18-jähriger Patient nach einer offenen Sprunggelenkfraktur ein Toxic-shock-Syndrom (TSS). Dieses potenziell lebensbedrohliche Krankheitsbild ist gekennzeichnet durch die Leitsymptome Fieber, Hypotension und Exanthem. Ursächlich sind meist staphylogene Toxine wie das Toxic-shock-Syndrom-Toxin-1 (TSST-1) und die Staphylokokken-Enterotoxine A–D. Fulminante Krankheitsverläufe mit kardiopulmonaler Dekompensation bis hin zum Multiorganversagen mit letalem Ausgang sind möglich.

Abstract

The treatment of open fractures is a challenge for the attending surgeon. Depending on the severity, the risk of infection rises up to 50 %. Local infection up to the point of sepsis can develop in spite of surgical and antimicrobial therapy. The present case demonstrates the case of an 18-year-old man who developed toxic shock syndrome (TSS) after an open ankle fracture. This potentially life-threating syndrome usually presents with the main symptoms of fever, hypotension and exanthema and is caused by toxins, such as toxic shock syndrome toxin 1 (TSST-1) and staphylococcal enterotoxins A–D. In some cases it is associated with cardiopulmonary decompensation and can rapidly progress to multiorgan failure.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. T. Klüter, S. Fitschen-Oestern, M. Weuster, H. Fickenscher, A. Seekamp und S. Lippross geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Klinik für Unfallchirurgie (Traumatologie), Universitätsklinikum Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3, 24105, Kiel, Deutschland

    T. Klüter, S. Fitschen-Oestern, M. Weuster, A. Seekamp & S. Lippross

  2. Institut für Infektionsmedizin, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Deutschland

    H. Fickenscher

Authors
  1. T. Klüter
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  2. S. Fitschen-Oestern
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  3. M. Weuster
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  4. H. Fickenscher
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  5. A. Seekamp
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  6. S. Lippross
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Correspondence to T. Klüter.

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Klüter, T., Fitschen-Oestern, S., Weuster, M. et al. Toxic-shock-Syndrom nach offener Sprunggelenkverletzung. Unfallchirurg 118, 643–646 (2015). https://doi.org/10.1007/s00113-014-2659-3

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  • DOI: https://doi.org/10.1007/s00113-014-2659-3

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