Abstract
PURPOSE: This study was conducted to report the rare combination of necrotizing fasciitis and toxic shock syndrome, which both complicated neglected sacrococcygeal pilonidal sinus disease. METHODS: A case report is presented. RESULTS: We describe the rare case of a previously healthy adult male patient who developed necrotizing fasciitis and toxic shock syndrome associated with Streptococcus pyogenes and Bacteroides fragilis.Patient's response to emergency surgery followed by repeated debridements of necrotic tissue, together with aggressive fluid resuscitation, broad-spectrum antibiotic coverage, and hyperbaric oxygenation was good. CONCLUSION: This case serves again as a clear reminder that neglected pilonidal sinus disease can lead to unusual and life-threatening consequences.
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References
Allen-Mersh TG. Pilonidal sinus: findings the right track for treatment. Br J Surg 1990;77:123–32.
Brook I. Microbiology of infected pilonidal sinuses. J Clin Pathol 1989;42:1140–2.
Johnson CC, Finegold SM. Anaerobic infections in surgery. Probl Gen Surg 1993;10:579–94.
Stevens DL. Streptococcal toxic-shock syndrome: spectrum of disease, pathogenesis, and new concepts in treatment. Emerg Infect Dis 1995;1:69–78.
Dellinger EP. Necrotizing soft-tissue infections. In: Davis JM, Shires GT, eds. Principles and management of surgical infections. Philadelphia: JB Lippincott, 1991:23–39.
Stevens DL. Invasive group A streptococcus infections. Clin Infect Dis 1992;14:2–13.
Di Tomaso A, Warner EA, Holt D, Ritrosky S. Case report: toxic shock syndrome arizing from cellulitis. Am J Med Sci 1994;308:110–11.
Gelshorn Ch, Piffaretti JC, Haldimann B, Martinoli S. Diarrhoe und Peritonitis Bei Sepsis durch Streptococcus beta-hemolyticus Typ A. Helv Chir Acta 1994;60:931–4.
Brantigan ChO, Senkowsky J. Group A beta hemolytic streptococcal necrotizing fasciitis. Wounds 1995;7:62–8.
Howard RJ, Simmons RL. Surgical infectious diseases. 2nd ed. New York: Appleton & Lange, 1988:404–42.
Shlasko E, Harris MT, Benjamin E, Iberti ThJ, Steinhagen RM. Toxic shock syndrome after pilonidal cystectomy: report of a case. Dis Colon Rectum 1991;34:502–5.
Panov TA, Kjossev KT, Losanoff JE. Life-threatening streptococcal myonecrosis complicating primary wound closure after pilonidal sinus excision. J R Army Med Corps 1994;140:141–2.
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Velitchkov, N., Djedjev, M., Kirov, G. et al. Toxic shock syndrome and necrotizing fasciitis complicating neglected sacrococcygeal pilonidal sinus disease. Dis Colon Rectum 40, 1386–1390 (1997). https://doi.org/10.1007/BF02050828
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DOI: https://doi.org/10.1007/BF02050828