Toxic shock syndrome without rash in a young child: Link with syndrome of hemorrhagic shock and encephalopathy?
| Autor: | Jan Ceuppens, Wijnanda J. van Leeuwen, Stefaan Van Lierde, Luc Cornette, Johan Van Eldere, Patrick Goubau |
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| Rok vydání: | 1997 |
| Předmět: |
Staphylococcus aureus
Pathology medicine.medical_specialty Fever genetic structures Bacterial Toxins Encephalopathy Erythroderma Shock Hemorrhagic Staphylococcal infections Gastroenterology Diagnosis Differential Desquamation Enterotoxins Interferon-gamma Lymphadenitis Internal medicine medicine Superantigen Humans Brain Diseases Superantigens Interleukin-6 Tumor Necrosis Factor-alpha business.industry Infant Toxic shock syndrome Syndrome Staphylococcal Infections bacterial infections and mycoses medicine.disease Shock Septic Rash Shock (circulatory) Pediatrics Perinatology and Child Health Female Lymph Nodes medicine.symptom business Dermatitis Exfoliative |
| Zdroj: | The Journal of Pediatrics. 131:130-134 |
| ISSN: | 0022-3476 |
| Popis: | A diffuse macular erythroderma and subsequent desquamation after 1 to 2 weeks are two of the five major diagnostic criteria of toxic shock syndrome (TSS). We present the case of a 15-month-old girl with TSS, but without erythroderma or desquamation. She was admitted with high fever, shock, and multiorgan involvement. Minimal or no cutaneous signs were present. Initially the diagnosis of the syndrome of hemorrhagic shock and encephalopathy was made. After 7 days, a TSS toxin 1-producing strain of Staphylococcus aureus was cultured from an inguinal lymph node, where inflammation had already been noticed on admission. Moreover, the girl had no antibodies against this toxin. The serum cytokine profile during the acute phase of her illness showed high levels of tumor necrosis factor-alpha, interleukin-6 and interferon-gamma, as is seen during activation of the immune system by TSS toxin 1. Other possible causes for the patient's illness were excluded. We conclude that the patient had TSS without rash. Without the evidence implicating a TSS toxin 1-producing strain of S. aureus as the cause of her disease, a diagnosis of syndrome of hemorrhagic shock and encephalopathy would have been made. It is possible that some cases of syndrome of hemorrhagic shock and encephalopathy represent a variant of TSS in small children. |
| Databáze: | OpenAIRE |
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