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