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Toxic shock syndrome occurring in children with abrasive injuries beneath casts

P W Spearman1, W J Barson

  • 1Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri.

Insights

Staphylococcal toxic shock syndrome can occur in children with skin infections under casts. This highlights a hidden infection source for this serious condition.

Area of Science:

  • Pediatric Infectious Diseases
  • Dermatology
  • Orthopedics

Background:

  • Staphylococcal toxic shock syndrome (TSS) is a serious condition often associated with menstruation.
  • Non-menstrual TSS has been documented in various settings, including post-operative orthopedic wound infections.

Observation:

  • Two pediatric cases of TSS are presented.
  • Infections were focal cutaneous staphylococcal infections located beneath casts used for limb immobilization.

Findings:

  • These cases reveal a previously unrecognized site for staphylococcal infection leading to TSS.
  • Sub-cast infections represent a hidden source of staphylococcal toxins.

Implications:

  • Clinicians should consider TSS in children with casts presenting with systemic symptoms.
  • Early recognition and management of sub-cast infections are crucial to prevent TSS development.
  • This finding expands the understanding of potential TSS triggers in pediatric orthopedic patients.

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