Early recognition of this disease is important The host-pathogen interaction, virulence factors, and the absence or presence of host immunity determines the epidemiology, clinical syndrome, and outcome. Toxins produced by staphylococci and streptococci act as superantigens that can activate the immune system by bypassing the usual antigen-mediated immune-response sequence. TSS is thought to be a superantigen-mediated disease. Mortality associated with streptococcal TSS is 5-10% in children, much lower than in adults (30-80%), and is 3-5% for staphylococcal TSS in children. Bacteremia is more common in streptococcal TSS than in staphylococcal TSS. Sites of infection in streptococcal TSS are much deeper than in staphylococcal TSS, such as infection caused by blunt trauma, and necrotizing fasciitis. Streptococcal TSS occurs most commonly following varicella or during the use of NSAIDs. The incidence of streptococcal TSS remains constant after its resurgence, but varies with geographic location. Nonmenstrual TSS and menstrual TSS are now reported with almost equal frequency. Changes in the manufacturing and use of tampons led to a decline in staphylococcal TSS over the past decade, while the incidence of nonmenstrual staphylococcal TSS increased. Both TSS and the toxic shock-like syndrome occur at a lower incidence in children than in adults. Since the late 1980s, a resurgence of highly invasive streptococcal infections, including a toxic shock-like syndrome, was noted worldwide and a consensus case definition for streptococcal TSS was subsequently proposed in 1993. A case definition for staphylococcal TSS was well established in the early 1980s and helped in defining the epidemiology. TSS reflects the most severe form of the disease caused by Staphylococcus aureus and Streptococcus pyogenes. Toxic shock syndrome ( TSS) is an acute, toxin-mediated illness, like endotoxic shock, and is characterized by fever, rash, hypotension, multiorgan involvement, and desquamation. Toxic shock syndrome in children: epidemiology, pathogenesis, and management.Ĭhuang, Yu-Yu Huang, Yhu-Chering Lin, Tzou-Yien TSS may be underrecognized among all ages and both sexes. The incidence of staphylococcal TSS did not change significantly overall or in female patients 10–49 years of age but increased for streptococcal TSS. In Colorado, USA, diagnoses coded as toxic shock syndrome ( TSS) constituted 27.3% of infectious shock cases during 1993–2006. Infectious Shock and Toxic Shock Syndrome Diagnoses in Hospitals, Colorado, USA The incidence of staphylococcal TSS did not change significantly overall or in female patients 10-49 years of age but increased for streptococcal TSS. In Colorado, USA, diagnoses coded as toxic shock syndrome ( TSS) constituted 27.3% of infectious shock cases during 1993-2006. Smit, Michael A Nyquist, Ann-Christine Todd, James K Infectious shock and toxic shock syndrome diagnoses in hospitals, Colorado, USA.
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