Toxic shock syndrome caused by staphylococcus (MRSA detected)
Last Updated: 2019-08-26
ICD11: -
Last Updated: 2019-08-26
Author(s): Anzengruber F., Navarini A.
ICD11: -
Todd et al. 1978.
Toxic-Shock-Syndrome, TSS.
Superantigen-producing staphylococcal disease with scarlatinous exanthema and reduced general condition. In the process, it can lead to shock and multiorgan failure.
No other germ detection (except possibly Staphylococcus aureus, however the detection of S. aureus is not essential to make the diagnosis).
Blood count (anemia, leukocytosis with neutrophilia, thrombocytopenia), coagulation (consumption coagulopathy, prolonged prothrombin time and partial thromboplastin time), creatinine, Urea (renal insufficiency), transaminases, bilirubin (liver insufficiency), creatinine kinase (myalgia), electrolytes (hyponatremia, hypalbuminemia, hypocalcemia, hypophosphatemia),
Blood culture (pathogen detection), U status.
CNS symptoms (encephalopathy with disorientation, confusion, epileptic seizures, cerebral edema, headache, memory loss, poor concentration): Neurological consil and cerebrospinal puncture.
Exclusion of a vaginal/intrauterine foreign body.
Women with M-STSS should no longer use tampons. Spirals for contraception should also be avoided.
Blood pressure monitoring.
CAVE: Postoperative wounds can be clinically unremarkable, but still act as a focus of infection.
Systemic Therapy
Clindamycin has clearly shown itself superior to ampicillin.
Clindamycin intravenously 3x daily 900 mg (adults), 3x 25-40mg/kg/d (children).
AND
With proven MRSA infection
AND
OR
AND
In case of skin infection
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