Toxic Shock Syndrome

Question 1

What is toxic shock syndrome?

Answer 1

• An acute febrile illness resulting in multiple organ system dysfunction
• Caused most commonly by Staph aureus EXOtoxin

Question 2

What most commonly causes toxic shock syndrome?

Answer 2

• Staph aureus EXOtoxin

Question 3

What are the clinical features of toxic shock syndrome?

Answer 3

• Acute febrile illness
• Hypotension
• Erythematous (sunburn-like) rash which desquamates during recovery
• Watery diarrhea
• Vomiting
• Vascular collapse

Question 4

Menstruation association toxic shock syndrome is associate with the use of what? (3)

Answer 4

• Tampons
• Diaphragm
• Vaginal sponge

Question 5

What is associated with non-menstruation toxic shock syndrome?

Answer 5

• peurpural sepsis
• post c-section endometritis
• mastitis
• sinusitis
• wound/skin infection
• nasal packing
• PID
• Burns

Question 6

How would you manage a patient with toxic shock syndrome?

Answer 6

• ABC
• ICU admit
• Fluid resuscitation
• Seach for localized infection
• Remove potential infection source (tampon, debride wound, incision and drainage of abscess)
• Evaluate for organ failure (renal, resp, cardiac, hepatic..)
• Antibiotic use clindamycin plus vancomycin

Question 7

Is the mortality higher in staph or strep TSS?

Answer 7

Strep - 30%

Staph - 3%