| Streptococcal toxic-shock syndrome is defined | | | | 2.Sunburn-like rash. |
| group A streptococcal infection. It is | | | | |
| associated with the early onset of shock and | | | | 3.Diarrhoea. |
| organ failure. It can be caused by one of | | | | |
| two different types of bacteria, | | | | 4.Fever. |
| Staphylococcus aureus and Streptococcus | | | | |
| pyogenes. This bactria affects the whole | | | | 5.Muscle aches. |
| body. Staphylococcus can produce toxins. In | | | | |
| some people whose bodies can't fight these | | | | 6.Dizziness. |
| toxins, the immune system reacts. Most often | | | | |
| STSS appears after streptococcus bacteria | | | | 7.Confusion. |
| have invaded areas of injured skin, such as | | | | |
| cuts and scrapes, surgical wounds, and even | | | | Treatment of Toxic Shock Syndrome |
| chickenpox blisters. It almost never follows | | | | |
| a simple streptococcus throat infection | | | | 1.Toxin production: Drain or debride the |
| (strep throat). The symptoms of TSS include | | | | lesion, remove foreign material, and irrigate |
| sudden high fever, a faint feeling, watery | | | | copiously. Recent surgical wounds should be |
| diarrhea, headache, and muscle aches. If your | | | | explored and irrigated even when signs of |
| child has these symptoms, it's important to | | | | inflammation are absent. |
| call your child's doctor right away. | | | | |
| | | | 2. Aggressive fluid resuscitation: Loss of |
| S. aureus commonly colonizes skin and mucous | | | | fluid into the extravascular compartment can |
| membranes in humans. TSS has been associated | | | | be very substantial. Maintenance of cardiac |
| with use of tampons and intravaginal | | | | filling pressures is critical in order to |
| contraceptive devices in women. In the United | | | | prevent end organ damage. Adult patients with |
| States, annual incidence is 1-2/100,000 women | | | | TSS have required up to 10 L of fluid in the |
| 15-44 years of age.Other risk factors for | | | | first 24 hr. |
| toxic shock syndrome include skin wounds and | | | | |
| surgery. Signs and symptoms of toxic shock | | | | 3. Administration of antistaphylococcal |
| syndrome develop suddenly, and the disease | | | | antibiotics: Semisynthetic penicillins have |
| can be fatal. Almost every organ system can | | | | been widely used for TSS. Recommends |
| be involved, including the cardiovascular, | | | | treating suspected TSS patients with |
| renal, skin, mucosa, GI, musculoskeletal, | | | | clindamycin (900 mg i.v. every 8 hours for |
| hepatic, hematologic, and central nervous | | | | adults; 13 mg/kg i.v. every 8 hours for |
| systems. Toxins produced by the staph or | | | | children), either alone or in combination |
| strep bacteria and accompanying hypotension | | | | with a cell wall active agent (semisynthetic |
| may result in kidney failure. If your kidneys | | | | penicillin or vancomycin). If the diagnosis |
| fail, you may need dialysis. Always use a | | | | of TSS is initially uncertain, broader |
| tampon with the lowest absorbancy suitable | | | | empiric coverage is appropriate. |
| for your period flow and use a sanitary | | | | |
| towel or panty liner from time to time during | | | | 4.General supportive care: Intensive care |
| your period. | | | | monitoring is often indicated. Replete |
| | | | calcium and magnesium; provide ventilatory, |
| Causes of Toxic Shock Syndrome | | | | pressor, and inotropic support; manage |
| | | | rhabdomyolysis, renal dysfunction, and / or |
| 1.Use of superabsorbent tampons. | | | | coagulopathy. |
| | | | |
| 2.Postpartum toxic shock. | | | | 5.Administration of pooled human |
| | | | immunoglobin: This should be reserved for |
| 3.Nasal packing. | | | | refractory cases or cases associated with an |
| | | | undrainable focus of infection. All |
| 4.Common bacterial infections. | | | | commercial immunoglobulin preparations |
| | | | contain high levels of anti-TSST-1 antibody. |
| 5.Viral infection with influenza A or | | | | A single infusion of 400 mg/kg i.v. will |
| varicella. | | | | generate a protective titre in a nonimmune |
| | | | patient |
| 6.Diabetes mellitus. | | | | |
| | | | 6.Toxins produced by the staph or strep |
| Symptoms of Toxic Shock Syndrome | | | | bacteria and accompanying hypotension may |
| | | | result in kidney failure. If your kidneys |
| 1.Vomiting. | | | | fail, you may need dialysis. |
| | | | |