ASIMJANI, Infectious Disease Emergencies: Part 2, Septic and Nonseptic Febrile Syndromes

摘要

The diagnosis of stophylo-coccal toxic shock syndrome (TSS) is largely clinical because Staphylococcus aureus is rarely recovered from blood cultures. Patients with staphylococcal TSS have fever, hypotension (initially presenting as orthostatic dizziness or syncope), and skin manifestations (diffuse erythroderma, pruritic maculo-papular rash, and desquamation). Symptoms or history of present illness that are more suggestive of streptococcal TSS than of staphylococcal TSS include recent trauma, severe pain, and physical findings of soft tissue infections (ie, localized swelling and erythema, followed by ecchymosis and sloughing of skin). Another distinguishing feature of streptococcal TSS is that Streptococcus pyogenes is readily recovered from blood cultures.