# Thyroidectomy Complicated by Severe Septic Shock Due to Streptococcus pyogenes: A Case Study

## TL;DR

A 45-year-old woman developed severe septic shock from Streptococcus pyogenes after thyroid cancer surgery, highlighting the risks and importance of preoperative care.

## Contribution

This case study highlights the rare but severe complication of necrotizing mediastinitis due to Streptococcus pyogenes after thyroidectomy.

## Key findings

- The patient experienced sudden cardiac arrest due to septic shock caused by Streptococcus pyogenes.
- Long-term interdisciplinary treatment was required for recovery.
- The case emphasizes the importance of preoperative assessment and infection awareness in surgical teams.

## Abstract

Background: In recent years, the incidence of thyroid cancer has been increasing due to environmental, biological, and genetic factors. One of the treatment methods for thyroid cancer is strumectomy, a procedure associated with a high risk of postoperative complications. Methods: The following case presents septic shock with sudden cardiac arrest and cardiopulmonary resuscitation, caused by Streptococcus pyogenes, in a 45-year-old woman who underwent surgery for papillary carcinoma. Results: The patient required long-term interdisciplinary treatment in the Clinical Department of Anesthesiology and Intensive Care. Conclusions: Necrotizing mediastinitis after thyroidectomy caused by Streptococcus pyogenes is a rare and dangerous complication. The analysis of the case proves how important the preoperative assessment of the patient’s health (especially taking a detailed history) and the patients’ awareness of possible risk factors are. An equally important aspect is the awareness of the therapeutic team regarding the transmission of infections, their dynamics, and the consequences of the procedures undertaken.