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Toxic Shock Syndrome, Pediatric

Amanda C. Schondelmeyer, MD, MSc and Erin E. Shaughnessy, MD, MSHCM Reviewed 10/2018
 


BASICS

DESCRIPTION

Toxic shock syndrome (TSS) is an acute febrile illness characterized by hypotension and gastrointestinal and respiratory distress progressing to multisystem organ failure. The clinic...

DIAGNOSIS

HISTORY

  • Patients may report use of tampons, contraceptive sponge, or diaphragm.

    • TSS may occur at any time during menses.

  • Inquire about recent wounds or surgical procedures including catheters (...

TREATMENT

MEDICATION

1st-line therapy should be broad initially and guided by local rates of methicillin-resistant S. aureus (MRSA). 
  • Vancomycin IV (15 mg/kg every 6 hours, max daily dose 4,000 mg) shou...

ONGOING CARE

Aside from antimicrobial therapy, the mainstays of treatment are supportive care for organ dysfunction. 

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Temperature usually returns to normal wi...

ADDITIONAL READING

  • Adalat S, Dawson T, Hackett S, et al. Toxic shock syndrome surveillance in UK children. Arch Dis Child.  2014;99(12):1078–1082. [View Abstract on OvidInsights]

  • Bisno AL, Stevens...

CODES

ICD9

  • 040.82 Toxic shock syndrome

  • 041.11 Methicillin susceptible Staphylococcus aureus in conditions classified elsewhere and of unspecified site

  • 041.01 Streptococcus infection in conditions classif...

FAQ

  • Q: Can TSS recur?

  • A: Yes. Inadequate eradication of the nidus of infection or inadequate treatment may result in recurrence. Poor immune function may also contribute to recurrence.

  • Q: Can TSS be dia...

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