In this case report, we present a 5-year-old child who presented with a septic arthritis of the knee, whose final diagnosis was streptococcal toxic shock syndrome. [ncbi.nlm.nih.gov]

• Fever

  Streptococcal toxic shock syndrome should be considered in paediatric patients with fever, vomiting, diarrhoea, abdominal pain and early shock. [ncbi.nlm.nih.gov]

• Constitutional Symptom

  All of them had constitutional symptoms such as fever, vomiting, diarrhoea, abdominal pain and physical findings of tachycardia and diffuse abdominal tenderness, but no concomitant skin infection. [ncbi.nlm.nih.gov]

• Inguinal Hernia

  In patient 1 the syndrome was associated with the development of necrotizing fasciitis following inguinal hernia repair. Patient 2 suffered from StrepTSS shortly after receiving a tetanus vaccine in her left deltoid. [ncbi.nlm.nih.gov]

• Aspiration

  Group A streptococci were cultured from both blood and pus aspirate from knee joint. The patient had signs of STSS. Early radical drainage debridement plus appropriate antibiotic therapy altered the usual devastating outcome. [ncbi.nlm.nih.gov]

  Laboratory findings include: leucocytosis, Gram-stain smears from an aspirate or debrided tissue containing Gram-positive cocci, elevated creatine kinase (in NF/myositis) and bacteraemia. [frca.co.uk]

• Tachypnea

  Phase 2: During this stage, the initial symptoms of phase 1 continue, with the addition of systemic derangements such as onset of tachycardia and tachypnea. If pain is present due to a focal infection, it may continue to increase in severity. [clinicaladvisor.com]

  Upon transfer to the Genius General Hospital ICU, she was found to have a mean arterial pressure (MAP) in the low 50s with tachycardia, moderate tachypnea, and a lactate of 10 mM. [emcrit.org]

• Abdominal Pain

  Streptococcal toxic shock syndrome should be considered in paediatric patients with fever, vomiting, diarrhoea, abdominal pain and early shock. [ncbi.nlm.nih.gov]

• Abdominal Tenderness

  She was found to have sepsis, shock abdominal tenderness and an erythematous rash. She was managed with intravenous antibiotics and fluid resuscitation. [ncbi.nlm.nih.gov]

• Hypotension

  The patient presented with hypotension, coagulation defects, adult respiratory distress syndrome and scarlet exanthema as a complication of hemolytic group A streptococcal endometritis. [ncbi.nlm.nih.gov]

• Tachycardia

  All of them had constitutional symptoms such as fever, vomiting, diarrhoea, abdominal pain and physical findings of tachycardia and diffuse abdominal tenderness, but no concomitant skin infection. [ncbi.nlm.nih.gov]

  […] staphylococcus (tampon, swab, infected skin lesion, respiratory tract, post partum, osteomyelitis) systemic symptoms (fever, chills, rigors) myalgia GI upset – vomiting and diarrhoea headache sore throat shock with multi-organ failure EXAMINATION fever tachycardia [lifeinthefastlane.com]

  This cytokine storm is thought to drive the rapid onset of hypotension, fever, tachycardia, and multiorgan failure so characteristic of the toxic shock syndromes. [infectiousdiseaseadvisor.com]

  Phase 2: During this stage, the initial symptoms of phase 1 continue, with the addition of systemic derangements such as onset of tachycardia and tachypnea. If pain is present due to a focal infection, it may continue to increase in severity. [clinicaladvisor.com]

  Upon transfer to the Genius General Hospital ICU, she was found to have a mean arterial pressure (MAP) in the low 50s with tachycardia, moderate tachypnea, and a lactate of 10 mM. [emcrit.org]

• Palpable Purpura

  Palpable purpura resulting from cocaine and levamisole coingestion has been reported with increasing frequency over the last several years as distribution of this drug combination becomes more universal. [ncbi.nlm.nih.gov]

• Musculoskeletal Pain

  Streptococcal toxic shock syndrome often presents with complaints of musculoskeletal pain, which frequently leads to early involvement of an orthopaedic surgeon. [ncbi.nlm.nih.gov]

• Knee Effusion

  While awaiting oral penicillin he became hypotensive refractory to IV fluids and developed knee effusion. The patient noted progressive dimming of his vision. Arthrocentesis yielded GAS. [ncbi.nlm.nih.gov]

• Leg Pain

  Several hours after admission, leg pain and purpura-like skin color appeared. [ncbi.nlm.nih.gov]

• Oliguria

  Despite improved circulation over the next 2 days, he developed oliguria, progressive fluid overload, generalised oedema and a right-sided pleural effusion. Dialysis was commenced on day 3 of admission. [ncbi.nlm.nih.gov]

  Some experts recommend use when there has been no clinical response after the first 6 hours of supportive therapy, or in cases in which an undrainable focus or persistent oliguria with pulmonary edema are present. [clinicaladvisor.com]

• Vaginal Bleeding

  A 43-year-old woman presented with fevers, vaginal bleeding and abdominal pain after an office endometrial biopsy. She was found to have sepsis, shock abdominal tenderness and an erythematous rash. [ncbi.nlm.nih.gov]

Treatment is primarily surgical debridement of infected tissue with supportive care, antibiotics, and hemodynamic monitoring. [ncbi.nlm.nih.gov]

The remaining 40% are menstrual related and have a better prognosis. [errolozdalga.com]

Early diagnosis with effective treatment can yield a good prognosis; development of organ damage usually worsens the patient's prognosis. [medicinenet.com]

Prognosis The prognosis is variable. Many people recover completely while others may die even with prompt treatment in the hospital. [drugs.com]

Activated protein C was therefore withdrawn in 2011. [ 13 ] Prognosis Mortality rate for TSS is around 5-15%. A fatality rate of up to 64% has been noted in cases of STSS in the UK. [ 3 ] Recurrence of TSS is found in 30-40% of cases. [patient.info]

Prognosis [ edit ] With proper treatment, people usually recover in two to three weeks. [ citation needed ] The condition can, however, be fatal within hours. [en.wikipedia.org]

This small series supports recognition of group G Streptococcus in the etiology of STSS. We propose intravenous immunoglobulin be used in treatment as it is for STSS caused by group A Streptococcus. [ncbi.nlm.nih.gov]

On the other hand, there appears to be some symptoms and signs that may assist in distinguishing between the 2 etiologies. [lessons4medicos.blogspot.com]

For suspected toxic shock of unknown etiology, a regimen containing antistaphylococcal gram-positive coverage as well as the addition of clindamycin are typically indicated. [clinicaladvisor.com]

Use Additional Use Additional Help Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10data.com]

This study aims to describe the epidemiology of streptococcal TSS in children and to determine whether adjunctive therapy with IVIG is associated with improved outcomes. [ncbi.nlm.nih.gov]

The presentation, pathophysiology, and management of invasive group A streptococcus and streptococcal toxic shock syndrome are reviewed. [ncbi.nlm.nih.gov]

Streptococcal Toxic Shock Syndrome (TSS) most frequently occurs in the setting infection due to group A Streptococcus (GAS; Streptococcus pyogene) Pathophysiology: Superantigens ! [ucsfmed.wordpress.com]

Epidemiology incidence staphylococcal toxic shock syndrome is more common in women due to tampon use typically occurs within 5 days of onset of menses in women using tampons Etiology Staphylococcus aureus group A Streptococcus ( Streptococcus pyogenes ) Pathophysiology [medbullets.com]

Aggressive and timely treatment are essential to preventing death. [ncbi.nlm.nih.gov]

The Working Group on Prevention of Invasive Group A Streptococcal Infections: Prevention of invasive group A streptococcal disease among household contacts of case-patients. Is prophylaxis warranted ? JAMA 1998, 279 ( 15 ):1206–1210. [link.springer.com]

JAMA. 1993 Jan 20;269(3):390-1. [2] Centers for Disease Control and Prevention. [bestpractice.bmj.com]