ad
This Article
Right arrow Images Only
Right arrow Full Version
Right arrow PDF Español
Right arrow Additional Image
Services
Right arrow E-mail this link to a friend
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Right arrow Section 1
Section 2
Section 3
Section 4
Section 5
Appendices
Right arrow Earn CME - What's This?
Related Collections
Right arrowRelated Articles

The following text is from an archived Red Book® edition and may not reflect current recommendations or information. To view the current edition, click here.

Section 3. Summaries of Infectious Diseases

Toxic Shock Syndrome

Clinical Manifestations
Etiology
Epidemiology
Diagnostic Tests
Treatment
Isolation of the Hospitalized Patient
Control Measures

Top
 Next
CLINICAL MANIFESTATIONS: Toxic shock syndrome (TSS) may be caused by toxin-producing Staphylococcus aureus or Streptococcus pyogenes (group A streptococci). Both organisms cause an acute illness characterized by fever, rapid-onset hypotension, rapidly accelerated renal failure, and multisystem organ involvement (see Tables 3.62, p 625, and 3.63, p 626). Profuse watery diarrhea, vomiting, generalized erythroderma, conjunctival injection, and severe myalgias commonly are present with S aureus-mediated TSS but are less common with S pyogenes-mediated TSS. Evidence of local soft tissue infection (eg, cellulitis, abscess, myositis, or necrotizing fasciitis) associated with severe increasing pain is common with S pyogenes-mediated TSS but not with S aureus-mediated TSS. The presence of a foreign body at the site of infection is common with S aureus-mediated TSS, but not with S pyogenes-mediated TSS. Both forms of TSS may occur without a readily identifiable focus of infection. Both forms of TSS also may be associated with invasive infections, such as pneumonia, osteomyelitis, bacteremia, pyarthrosis, or endocarditis. Patients with S aureus-mediated TSS, especially menses associated, are at risk of a recurrent episode of TSS. Recurrent episodes have not been reported for S pyogenes-mediated TSS. Toxic shock can be confused with many infectious and noninfectious causes of fever with mucocutaneous manifestations.


View this table:
[in this window]
[in a new window]
  		Table 3.62. Staphylococcal Toxic Shock Syndrome: Clinical Case Definition1

View this table:
[in this window]
[in a new window]
  		Table 3.63. Streptococcal Toxic Shock Syndrome: Clinical Case Definition1


Top
 Previous
Next
ETIOLOGY: Staphylococcus aureus-mediated TSS usually is caused by strains producing toxic-shock syndrome toxin-1 (TSST-1). Most of these strains also produce . . . [Go to Full Text]


Related Articles

Staphylococcal Infections
Red Book 2003 2003: 561-573. [Extract] [Full Text]

Group A Streptococcal Infections
Red Book 2003 2003: 573-584. [Extract] [Full Text]