Abstract
Toxic-shock syndrome is an acute-onset, multiorgan illness that resembles severe scarlet fever. Superantigen activates a huge number of T-cells by linkage to a particular V βelement of the T-cell receptor, which directly associates with major histocompatibility complex (MHC) class II molecules. We report a 64-year-old man with superantigen toxic shock syndrome toxin-1 (TSST-1), who had severe hypoxemia caused by airway stenosis and septic shock due to a cervical abscess. He underwent emergency tracheostomy and cervical incision to remove the abscess. Septic ARDS developed despite intensive care. Here, septic ARDS refers to the respiratory index (R-index: A-aDO2/PaO2) increasing to 5.57 on day 10 in the ICU. Changes in TSST-1 were similar to the R-index. No correlation was seen between IL-6 and serum TSST-1 antigen during the ICU period, but a statistically significant correlation (r=0.813, p<0.05) between serum TSST-1 antigen and R-index was found in this case. These results suggest that serum TSST-1 antigen is a possible cause of ARDS.
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