A Fatal Case of Toxic-Shock Syndrome following Cholecystectomy

Abstract

Toxic-shock syndrome is less common in the United Kingdom than in the United States, and in both countries the majority of cases have been diagnosed in menstruating women (de Saxe et al., 1982). Reingold et al. (1982) reviewed 130 cases of non-menstrual related toxic-shock syndrome in the United States. They detailed specific criteria for case definition and quoted a fatality rate of 9.2 per cent. Only 17 of these cases were associated with infected surgical wounds and none followed cholecystectomy. The onset of symptoms was one to 64 days post-operatively (median two days), and in all but one of these cases the signs of wound infection were minimal. We describe a fatal case of toxic-shock syndrome which occurred in an elderly man 25 days after cholecystectomy where the focus of infection was a wound sinus.