Toxic shock syndrome
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Toxic shock syndrome (TSS) is a toxin-mediated disease caused by Staphylococcus aureus or Streptococcus pyogenes bacteria that results in shock and organ failure. It is associated with the use of tampons and barrier contraceptives. A 15-year-old female presented with headache, fever, rash, abdominal pain and vomiting consistent with TSS, having left a tampon in for over 12 hours. She received IV antibiotics and supportive care and was discharged after improvement. TSS is a medical emergency treated with antibiotics to reduce bacterial load and prevent further endotoxin production.
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Toxic shock syndrome
- 1. Toxic Shock Syndrome Janet Zhang M.D. 1/5/2012
Editor's Notes
- Working diagnosis of early Toxic Shock Syndrome
- Because the disease is toxin mediated
- (e.g. cesarean section)
- CDC diagnostic criteria for TSS
- 1 st antibiotic to decrease bacterial load and clindmycin inhibits synthesis of bacterial endotoxin
- 21 patients with streptococcal toxic shock syndrome randomized to high-dose IVIG vs. albumin placebo for 3 days, all patients given antibiotics and standard care, study terminated early due to low recruitment, 28-day mortality was 10% with IVIG vs. 36% with placebo (NNT 4) or 12.5% vs. 30% in subgroup with documented invasive group A streptococcal infections (NNT 6) but results were not statistically significant; no differences in prevalence of chronic organ failure or times to resolution of shock and to control of tissue infection; no apparent side effects (Clin Infect Dis 2003 Aug 1;37(3):333 in J Watch Online 2003 Sep 9) (J Med Case Reports 2007 Feb 16;1:5)