Tri-state toxic-shock syndrome study. II. Clinical and laboratory findings

Clinical and laboratory findings were examined in 80 nonfatal cases of toxic-shock syndrome (TSS) which occurred in women from Minnesota, Wisconsin, and Iowa between October 1, 1979, and September 19, 1980. Among the clinical and laboratory factors reviewed, the presence of physician-diagnosed shock was the factor that most significantly correlated with other organ involvement. Vomiting, mucous membrane hyperemia, myalgias, and abnormal urinalysis were the factors noted to be manifest as frequently in the absence as in the presence of shock. Twenty-seven patients had recurrent episodes of TSS. The use of antistaphylococcal antibiotics during the initial TSS episode and the subsequent discontinuation of tampon use were independently statistically significantly associated with a decreased risk of recurrent illness. Only 44 of 54 patients had cervical/vaginal cultures positive for Staphylococcus aureus, a result indicating that a negative cervical/vaginal culture does not preclude the diagnosis of TSS.