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Staphylococcal Toxic Shock Syndrome

Caleb J. Mentzer, DO Reviewed 04/2024
 


BASICS

DESCRIPTION

  • An acute toxin-mediated illness associated with Staphylococcus aureus infection (can also be associated with Streptococcus pyogenes)

  • Toxic shock syndrome (TSS) is characterized by sud...

DIAGNOSIS

Clinical criteria generally include: Fever, rash, hypotension and multisystem organ involvement 

HISTORY

  • Prodrome of 1 to 3 days that often includes malaise, myalgias, fever, chills, vomiting,...

TREATMENT

  • Inpatient; typically requires admission to intensive care unit for close monitoring

  • Aggressive surgical tissue dedridment with if high risk for necrotizing fasciitis associated with TSS.

GENERAL MEASURES

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Avoid continuous tampon use during menstruation.

  • Wound care/hygiene

DIET

As tolerated 

PROGNOSIS

  • Mortality: 4–22%; higher in older patients, nonmenstrual TSS, and if d...

REFERENCES

1
Pinto MPB. Staphylococcal toxic shock syndrome. J Hematop. 2023;16(3):189-190. doi: 10.1007/s12308-023-00547-6. PMID: 38175396.
2
Gottlieb M, Long B, Koyfman A. The Evaluation and Management...

ADDITIONAL READING

Wilkins AL, Steer AC, Smeesters PR, et al. Toxic shock syndrome—the seven Rs of management and treatment. J Infect. 2017;74(Suppl 1):S147-S152.  

SEE ALSO

Measles (Rubeola); Pancreatitis, Acute; Rocky Mountain Spotted Fever; Scarlet Fever 

CODES

ICD10

  • A48.3 Toxic shock syndrome

  • B95.62 Methicillin resis staph infct causing diseases classd elswhr

SNOMED

  • 18504008 Toxic shock syndrome (disorder)

  • 266096002 methicillin resistant Staphylococcus aur...

CLINICAL PEARLS

  • TSS is a rare, acute, toxin-mediated illness most commonly associated with S. aureus.

  • Historically, TSS was traditionally associated with the continuous use of superabsorbent tampons du...

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