Description
Caused by a bacterial infection, most often streptococci or staphylococci. The sources of bacteria include: retained vaginal tampons, nasal packing, abscesses, or surgical wounds. The bacteria produce toxins that cause the symptoms and the damage to the body. This disorder primarily affects young adults, particularly menstruating women. The onset of symptoms is sudden and frequently progresses very rapidly. Shock and death can occur.
Symptoms
High fever, widespread red rash resembling a sunburn (particularly involving the hands and soles of the feet), weak pulse, chills, malaise, nausea, vomiting, diarrhea, redness of the mucosal membranes (eyes, mouth, throat), confusion, seizures, headaches, muscle ache, hypotension (low blood pressure), a rash that peels 2 weeks after appearance.
Tests
Common tests used for diagnosis and treatment
Workup:
A history and physical exam will be performed. There is no one specific diagnostic test. The diagnosis is made based on identifying a high fever, low blood pressure, the distinctive rash, and ongoing damage to multiple organs.
Tests:
Pregnancy (BHCG) test, Complete blood count (CBC), Comprehensive metabolic panel (CMP), CT Scan, Electrocardiogram (EKG), Urinalysis (UA), X-ray
Other Specific Tests: Blood cultures, cultures of any foreign bodies
Specialists:
Pediatric Critical Care Medicine, Critical Care Medicine, Infectious Disease Medicine, Pediatric Infectious Disease Medicine
Workup:
A history and physical exam will be performed. There is no one specific diagnostic test. The diagnosis is made based on identifying a high fever, low blood pressure, the distinctive rash, and ongoing damage to multiple organs.
Tests:
Pregnancy (BHCG) test, Complete blood count (CBC), Comprehensive metabolic panel (CMP), CT Scan, Electrocardiogram (EKG), Urinalysis (UA), X-ray
Other Specific Tests: Blood cultures, cultures of any foreign bodies
Specialists:
Pediatric Critical Care Medicine, Critical Care Medicine, Infectious Disease Medicine, Pediatric Infectious Disease Medicine
Treatment
The sources that could be harboring the bacteria must be removed or drained including: any foreign materials (tampons, vaginal sponges, nasal packing), abscesses, or sites of infection. Treatments to restore the patient's vital functions will be delivered including: intravenous fluids, medications to increase the blood pressure, supplemental oxygen including mechanical ventilation, and dialysis if kidney failure is present. Intravenous antibiotics will also be administered.