Manifestations of Toxic Shock Syndrome in Children, Columbus, Ohio, USA, 2010–2017

Data are limited on the incidence and management of streptococcal toxic shock syndrome (TSS) and nonstreptococcal TSS in children. We aimed to define the clinical patterns of TSS at Nationwide Children’s Hospital in Ohio as they relate to published criteria, diagnostic decisions, and treatment optio...

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Bibliographic Details
Main Authors: Aliza Cook, Sarah Janse, Joshua R. Watson, Guliz Erdem
Format: Article
Language:English
Published: Centers for Disease Control and Prevention 2020-06-01
Series:Emerging Infectious Diseases
Subjects:
Online Access:https://wwwnc.cdc.gov/eid/article/26/6/19-0783_article
Description
Summary:Data are limited on the incidence and management of streptococcal toxic shock syndrome (TSS) and nonstreptococcal TSS in children. We aimed to define the clinical patterns of TSS at Nationwide Children’s Hospital in Ohio as they relate to published criteria, diagnostic decisions, and treatment options. Through retrospective chart reviews, we identified 58 patients with TSS (27 streptococcal, 31 nonstreptococcal) during January 2010–September 2017. We observed clinical and laboratory findings that are not part of TSS criteria, such as pyuria in streptococcal TSS (50% of patients) and pulmonary involvement (85%) and coagulopathy (92%) in nonstreptococcal TSS patients. Recommended treatment with clindamycin and intravenous immunoglobulin was delayed in streptococcal TSS patients without rash (3.37 days vs. 0.87 days in patients with rash), leading to prolonged hospitalization and complications. Incorporation of additional TSS signs and symptoms would be helpful in TSS diagnosis and management.
ISSN:1080-6040
1080-6059