This is an answer to the Case – Rash on hand after cesarean section in association with fever and hypotension
A 33-year-old woman presented with a 4-day history of fever and abdominal pain, 7 days after undergoing a cesarean section. She had diffuse erythroderma, and the blood pressure was 85/48 mm Hg.
A workup revealed elevated creatinine and liver-enzyme levels, and specimens of urine and specimens from the vagina were cultured and grew Staphylococcus aureus.
Her condition worsened over the next day, with acute respiratory distress; subsequently, desquamation of her hands occurred. A diagnosis of staphylococcal toxic shock syndrome was made.
Desquamation is characteristic of staphylococcal toxic shock syndrome, typically occurring 1 to 2 weeks after the onset of illness and typically involving the palms and soles.
Staphylococcal toxic shock syndrome is associated with a wide variety of clinical settings, such as:
- menstruation
- postpartum and postsurgical states
- barrier contraceptive use
- staphylococcal pneumonia, sinusitis, and superinfected skin lesions
With supportive care and the administration of floxacillin, the patient recovered completely. The skin changes resolved within 4 weeks after the onset of illness.
