Journal Article

Recurrent Nonmenstrual Toxic Shock Syndrome: Clinical Manifestations, Diagnosis, and Treatment

Mary-Margaret Andrews, Eugene M. Parent, Michele Barry and Jeffrey Parsonnet

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 32, issue 10, pages 1470-1479
Published in print May 2001 | ISSN: 1058-4838
Published online May 2001 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/320170
Recurrent Nonmenstrual Toxic Shock Syndrome: Clinical Manifestations, Diagnosis, and Treatment

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We report 3 cases of recurrent nonmenstrual toxic shock syndrome (TSS) and review the clinical manifestations, diagnosis, and treatment. The primary sites of infection were the genital tract (in a patient who underwent cesarean delivery), the upper respiratory tract, and a breast abscess. In all 3 patients, the initial illness was not recognized to be TSS; only after development of recurrent illness with desquamation was this diagnosis entertained. Strains of Staphylococcus aureus that were isolated from 2 patients produced TSS toxin-1, whereas the third strain produced staphylococcal enterotoxin B. All 3 patients lacked antibody to the implicated toxins at the time of presentation with recurrent illness. Nonmenstrual TSS can occur in a variety of clinical settings and may be recurrent. The presence of desquamation during a febrile, multisystem illness could suggest this diagnosis and should prompt the clinician to obtain appropriate cultures for S. aureus.

Journal Article.  6776 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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