A Resected Case of Hepatocellular Carcinoma with Liver Cirrhosis Causing SSSS

Kazuki Yokoi, Akio Harada, Takumi Sakakibara, Yoshinao Komatu, Sigeru Yoshida, Toyohisa Yaguchi, Hiroya Murakami and Yoshiyuki Hukuhara

Department of Surgery, Aichi Prefectural Koseiren Kainan Hospital

A case of staphylococcal scalded skin syndrome (SSSS) after hepatectomy is reported. The patient was a 63-year-old male with liver cirrhosis, who was found to have a tumor in the liver by ultrasonography. Computed tomography and angiography showed hepatocellular carcinoma and partial hepatectomy was performed under thoracotomy and laparotomy. After the operation he had sepsis from a thoracic empyema, and showed peeling of the skin of all over the body. Nikolsky's sign was positive. MRSA was cultured from the pleural effusion, ascites and blood. He was diagnosed as SSSS and we performed thoracic drainage and gave intravenous antibiotics, which led to recovery. Almost all cases of SSSS in adults have some concomitant diseases. Liver cirrhosis, diabetes mellitus and extensive blood loss during hepatectomy was the cause of SSSS in our case. SSSS is rare in adults, and to our knowledge this is the first reported case after hepatectomy.

Key words
staphylococcal scalded skin syndrome in adults, liver cirrhosis, hepatectomy

Reprint requests
Kazuki Yokoi 58 Ohara, Machikatashinden, Saori-cho, Ama-gun, Aichi, 496-8014 JAPAN

Accepted
March 31, 1999

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