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Toxic Shock Syndrome: Still a Timely Diagnosis
Kira L Gossack-Keenan1,2, April J Kam1,2
1From the Michael G. DeGroote School of Medicine.
Pediatric Emergency Care
|October 18, 2017
Summary
Toxic shock syndrome (TSS), a severe toxin-mediated illness, requires prompt recognition and treatment. Early diagnosis and intervention are crucial for improving outcomes in young females presenting with shock symptoms.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Toxicology
Background:
- Toxic shock syndrome (TSS) is an acute, severe, toxin-mediated disease.
- Characterized by fever, hypotension, and multiorgan system involvement.
- Incidence declined after improved patient education and tampon labeling.
Purpose of the Study:
- To highlight the importance of recognizing and treating toxic shock syndrome.
- To emphasize the need for a high index of suspicion in young females presenting with shock.
Main Methods:
- A case report of a previously healthy 14-year-old girl presenting with TSS symptoms.
- Clinical presentation included fever, rash, vomiting, diarrhea, hypotension, and acute kidney injury.
- Diagnostic findings included thrombocytopenia, elevated white count and lactate, and positive vaginal swabs for Staphylococcus aureus and TSS toxin-1.
Main Results:
- The patient presented with symptoms consistent with septic shock.
- Investigations confirmed thrombocytopenia, elevated white count and lactate, and acute kidney injury.
- Vaginal swabs confirmed Staphylococcus aureus and TSS toxin-1.
Conclusions:
- Rapid recognition and treatment of TSS are crucial despite its decreased incidence.
- Emergency physicians should maintain a high index of suspicion for TSS in young females with unexplained shock.
- A pelvic examination is essential in evaluating such cases.