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Toxic shock syndrome and necrotizing fasciitis complicating neglected sacrococcygeal pilonidal sinus disease: Report of a case.

Velitchkov, Nadko M.D., Ph.D.; Djedjev, Marin M.D.; Kirov, Gueno M.D., Ph.D.; Losanoff, Julian M.D.; Kjossev, Kirien M.D.; Losanoff, Hristo M.D.
Diseases of the Colon & Rectum: November 1997
doi: 10.1007/BF02050828
Case Reports: PDF Only

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.

(C) The ASCRS 1997