Toxic shock and mortality in a dialysis patient
Background: Staphylococcus and Streptococcal infections are a matter of serious concern in the dialysis population especially those having tunnel catheter access. Importance of these organisms is their virulent nature, higher incidence and prevalence in tunnel catheters resulting in significant morbidity and mortality. Staphylococcal toxic shock syndrome (STSS) is an uncommon but potentially fatal disease with multisystem involvement. This is a case of toxin-producing methicillin sensitive staph aureus (MSSA) which is known to have high mortality. A high degree of clinical suspicion and prompt management is necessary to avoid fatality. The aim of the study was to get the idea for the management of the toxic shock in terms of reducing the morbidity and mortality rate.
Case presentation: This case progressed to state of shock within few hours of presentation to emergency room and admission, attributed to be toxic shock with multi-organ failure.
Management and Results: In the management of the patient at the very beginning, the infected catheter was removed further aggressive resuscitation and empirical antibiotics were administered but this case resulted into a fatality.
Conclusion: The early action for source removal of the infection, appropriate antibiotic therapy and adjuvant therapy including clindamycin and immunoglobulin can effectively treat the toxic shock and its related complications.
Barnett TC, Cole JN, Rivera‐Hernandez T, Henningham A, Paton JC, Nizet V, Walker MJ. Streptococcal toxins: role in pathogenesis and disease. Cell Microbiol. 2015; 17(12):1721-1741.
Lodies TP, Graves J, Evans A. Graffunder E, Helmecks M, Lomaestro BM, Stellrecht K. Relationship between vancomycin MIC and failure among patients with methicillin-resistant Staphylococcus aureus bacteremia treated with vancomycin. Anti microb Agents Chemother 2008; 52(9):3315-3320.
Reyes‐Robles T, Lubkin A, Alonzo F, Lacy DB, Torres VJ. Exploiting dominant‐negative toxins to combat Staphylococcus aureus pathogenesis. EMBO Rep. 2016 Feb 8:e201540994.
Szabo PA, Goswami A, Mazzuca DM, Kim K, O’Gorman DB, Hess DA, Welch ID, Young HA, Singh B, McCormick JK, Haeryfar SM. Rapid and rigorous IL-17A production by a distinct subpopulation of effector memory T lymphocytes constitutes a novel mechanism of toxic shock syndrome immunopathology. J Immunol. 2017: 198(7):2805-2818
Nguyen AT, Tallent SM. From Commensal to Consumer: Staphylococcus aureus Toxins, Diseases, and Detection Methods. J AOAC Int. 2018; 101(4):1127-1134.
Copyright (c) 2018 International Journal of Endorsing Health Science Research (IJEHSR)
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
By submitting a manuscript in IJEHSR, the Author (Authors if a multi-authored paper) confirms all the clause of the Copyright Notice