Staphylococcal toxic shock syndrome





Introduction

Staphylococcal toxic shock syndrome describes a severe systemic reaction to staphylococcal exotoxins, the TSST-1 superantigen toxin. It came to prominence in the early 1980s following a series of cases related to infected tampons.

Epidemiology

  • Incidence: 2.00 cases per 100,000 person-years
  • Peak incidence: 6-15 years
  • Sex ratio: more common in females 2:1
<1 1-5 6+ 16+ 30+ 40+ 50+ 60+ 70+ 80+

Clinical features

Centers for Disease Control and Prevention diagnostic criteria
  • fever: temperature > 38.9ÂșC
  • hypotension: systolic blood pressure < 90 mmHg
  • diffuse erythematous rash
  • desquamation of rash, especially of the palms and soles
  • involvement of three or more organ systems: e.g. gastrointestinal (diarrhoea and vomiting), mucous membrane erythema, renal failure, hepatitis, thrombocytopenia, CNS involvement (e.g. confusion)

Management

Management
  • removal of infection focus (e.g. retained tampon)
  • IV fluids
  • IV antibiotics