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Streptococcal Toxic Shock Syndrome
STSS

Presentation

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]

Entire Body System

  • Fever

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

  • Varicella-Zoster Virus Infection

    “Invasive group A streptococcal disease in children and association with varicella-zoster virus infection. Ontario Group A Streptococcal Study Group”. Pediatrics. vol. 105. 2000. pp. [clinicaladvisor.com]

Respiratoric

  • Tachypnea

    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]

    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]

Gastrointestinal

  • Abdominal Pain

    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]

  • Abdominal Tenderness

    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]

Cardiovascular

  • 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]

    Hypotension, myoglobinuria, and hemoglobinuria (due to toxin-induced hemolysis) can contribute. [ucsfmed.wordpress.com]

  • 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]

    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]

    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]

Musculoskeletal

  • 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]

Urogenital

  • 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

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

Prognosis

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

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

Etiology

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]

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

[…] of diseases in human communities. 2. the field of medicine concerned with the determination of the specific causes of localized outbreaks of infection, such as hepatitis, of toxic disorders, such as lead poisoning, or any other disease of recognized etiology [vdh.virginia.gov]

Epidemiology

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]

Pathophysiology

This paper discusses the similarities and differences between the two toxic states, reviews the pathophysiology, and presents a case report of near-fatal streptococcal toxic shock-like syndrome secondary to a puncture wound of the foot. [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]

Prevention

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

Because it is part of the body's normal bacteria, 90 percent of individuals develop antibodies to prevent infection. S. aureus can be transmitted by direct contact with infected persons. [stanfordchildrens.org]

CondYrID=858&DatePub=1/1/2010%2012:00:00%20AM or methicillin-sensitive (MSSA) or methicillin-resistant (MRSA) Staphylococcus aureus. [3] Centers for Disease Control and Prevention. [bestpractice.bmj.com]

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