A patient may develop Staphylococcal Toxic Shock Syndrome (TSS) following nasal surgery. The diagnosis can be easily missed since it is not usually considered in this patient population.
Clinical features:
(1) Staphylococcus aureus is isolated on culture.
(2) The patient has clinical findings consistent with TSS.
The presence of nasal packing material (including the nasal “tampon”) may increase the risk, but the syndrome can occur in the absence of packing material. If TSS is diagnosed in the setting of nasal packing then it should be removed.
Specialized laboratory findings that support the diagnosis:
(1) toxin production by the culture isolate
(2) absence of neutralizing antibody to the toxin
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