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Toxic shock syndrome in children aged 10 years or less
Insights
Pediatric toxic shock syndrome (TSS) in children under 10 presents similarly to adults but with more respiratory issues. Staphylococcus aureus was identified in cultures, and one case co-occurred with Kawasaki syndrome.
Area of Science:
- Pediatric Infectious Diseases
- Toxicology
- Critical Care Medicine
Background:
- Toxic shock syndrome (TSS) is a severe, multi-system illness.
- While commonly associated with menstruating women, TSS can affect children.
- Understanding pediatric TSS is crucial for early diagnosis and management.
Purpose of the Study:
- To review medical records of children diagnosed with toxic shock syndrome.
- To characterize the clinical presentation, course, and outcomes of pediatric TSS.
- To compare pediatric TSS with adult cases.
Main Methods:
- Retrospective review of medical records for seven pediatric patients meeting CDC case definition for TSS.
- Analysis of clinical symptoms, laboratory findings, and treatment outcomes.
- Microbiological cultures performed prior to antibiotic therapy.
Main Results:
- Seven children (four boys, three girls, aged 5-10 years) diagnosed with TSS.
- Common symptoms included fever, erythroderma, gastrointestinal issues, and hyperemia.
- Boys experienced more severe respiratory compromise requiring ventilation compared to girls.
- Staphylococcus aureus isolated from cultures in one patient.
- One boy presented with co-occurring Kawasaki syndrome and coronary aneurysms.
Conclusions:
- Pediatric TSS shares similarities with adult TSS but exhibits a higher incidence of respiratory compromise.
- Early recognition and management are vital, especially considering potential co-morbidities like Kawasaki syndrome.
Abstract:
Eight children aged 10 years or less had toxic shock syndrome, and medical records were reviewed for seven of them. There were four boys and three girls, ranging in age from 5 5/12 to 10 8/12 years; all seven met the Centers for Disease Control case definition of toxic shock syndrome. One boy died. The illness was generally characterized by fever, followed by erythroderma, gastrointestinal complaints, and mucous membrane hyperemia. Based on the need for supplemental oxygen or mechanical ventilation, the girls tended to have milder courses than the boys. In four of four cultures performed prior to the institution of antibiotic therapy. Staphylococcus aureus grew from one or more sites. One boy also met the case definition of Kawasaki syndrome and has had multiple coronary artery aneurysms demonstrated in early and late follow-up. Toxic shock syndrome in these children was similar to published descriptions of toxic shock syndrome in series of adult patients, except that, as a group, the children had a greater incidence of respiratory embarrassment.