Toxic Shock Syndrome Triggered by Thoracic Drain Insertion: A Pediatric Case Report.

introductionPostoperative Staphylococcus and streptococcal toxic shock syndrome (TSS) are associated with significant morbidity and mortality rates. As a result, surgical awareness is required to recognize and treat TSS appropriately. We report a pediatric case of TSS after thoracentesis for a pneumothorax. CASE PRESENTATION: A 14-year-old boy was diagnosed with a right pneumothorax and underwent thoracentesis with a trocar catheter. After 2 days, the patient developed a fever, headache, vomiting, and diarrhea. No obvious contamination of the drain puncture wound was observed. He was diagnosed with acute gastroenteritis and received intravenous treatment. On the 4th day after drainage, his blood pressure decreased. Due to suspected septic shock, he was transferred to the intensive care unit and administered antibiotics, immunoglobulin, and a hypertensive agent. His treatment response was good, and his general condition improved relatively quickly. On the 6th day, the patient was discharged from the intensive care unit. Although the air leak from the thoracic drain disappeared on day 3, the drain remained in place until day 8. Blood cultures obtained at the time of septic shock were all negative; however, pleural fluid and thoracic drain tip cultures detected

conclusionsTSS can occur after simple, routine procedures such as thoracentesis. Symptoms such as fever, rash, vomiting, and diarrhea should raise concern for TSS and prompt further exploration and cultures, even in benign-appearing postoperative wounds.