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[Toxic shock syndrome in children. Report of four cases]
A de Vincente Aymat1, A Martínez de Azagra, S Mencía Bartolomé
1Servicio de Cuidados Instensivos Pediátricos, Hospital Universitario del Niño Jesús, Universidad Autónoma de Madrid.
Insights
Four children diagnosed with toxic shock syndrome (TSS) recovered due to prompt, aggressive treatment. The study highlights potential staphylococcal origins and common infection entry points in pediatric cases.
Area of Science:
- Pediatrics
- Infectious Diseases
- Critical Care Medicine
Background:
- Toxic Shock Syndrome (TSS) is a severe, multi-system illness.
- Pediatric intensive care unit (PICU) admissions for TSS are rare but critical.
- Early diagnosis and treatment are vital for patient outcomes.
Observation:
- Four pediatric patients admitted to the PICU within one year were diagnosed with TSS.
- All patients met the established diagnostic criteria for TSS.
- Probable infection entry points included maxillary sinusitis, pneumonia, and surgical wounds.
Findings:
- No specific causative bacteria were isolated, suggesting a staphylococcal origin.
- Aggressive treatment, including inotropic support, fluid resuscitation, and antibiotics, led to good outcomes.
- Two patients developed adult respiratory distress syndrome (ARDS) requiring prolonged mechanical ventilation.
Implications:
- This case series underscores the importance of recognizing TSS in pediatric critical care.
- Prompt and aggressive management is crucial for favorable prognoses in children with TSS.
- Further research into the specific staphylococcal toxins and pathogenesis in pediatric populations is warranted.
Abstract:
We report four children with toxic shock syndrome admitted in the pediatric intensive care unit of our hospital during the past year. All the children had the five criteria established by the Centers for Disease Control for the diagnosis of this syndrome. In all four there was a probable point of entry of the infection: maxillar sinusitis in one, pneumonia in two and surgical wound in the other. No bacteria that could have caused the infection were isolated in any of the children, which suggests a staphylococcal origin for this syndrome. Evolution was good in all of the children due to aggressive treatment that included inotropic support, volemic expansion and antibiotics. Two of the children, who suffered adult respiratory distress syndrome, required prolonged respiratory support.