The Epidemiology of Pediatric Thermal Injury-associated Toxic Shock Syndrome: A Systematic Review

Thermal injury-associated toxic shock syndrome (TSS) is a life-threatening condition that can occur in children following burn injuries. The objective of this study was to describe the clinical manifestations, treatment, and outcomes of children who experienced TSS following a thermal injury. Additionally, the existing literature was systematically examined and published cases of pediatric TSS occurring after burns were compiled. In June 2023, without regard for time constraints, articles that met the criteria were searched across several electronic databases. The inclusion criteria were English-language publications, pediatric patients, and reported outcomes of interest for clinical questions. Due to the heterogeneity of the included publications and the lack of data in an appropriate format, a meta-analysis was not feasible. Our research identified 23 studies published between 1980 and 2023, including 72 cases (from multiple countries) that met the inclusion criteria. Of the 72 patients with thermal injuries complicated by TSS, 53 (73.6%) children survived, 6 (8.3%) died, and for 13 (18%) cases, the outcome was not documented. Our systematic review highlights the rarity, severity, and complexity of pediatric thermal injury-associated TSS. Key findings from the review indicate that pediatric thermal injury-associated TSS carries a high mortality rate and significant morbidity. By increasing awareness, improving diagnostic accuracy, and optimizing treatment strategies, healthcare professionals can improve patient outcomes in this challenging condition.