Toxic shock syndrome diagnostic criteria
|
Toxic shock syndrome Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Toxic shock syndrome diagnostic criteria On the Web |
|
American Roentgen Ray Society Images of Toxic shock syndrome diagnostic criteria |
|
Risk calculators and risk factors for Toxic shock syndrome diagnostic criteria |
Please help WikiDoc by adding more content here. It's easy! Click here to learn about editing.
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1],Associate Editor(s)-in-Chief: Mahshid Mir, M.D. [2]
Overview
The diagnostic criteria varies depend on the organism responsible for the Toxic Shock Syndrome (TSS), but mainly the diagnosis of TSS is based on the clinical presentation.
Diagnostic Criteria
Toxic Shock Syndrome (Other Than Streptococcal) (TSS)
Clinical Criteria
The diagnosis of Staphylococcal toxic shock syndrome (TSS) is based upon clinical presentation as no confirmatory diagnostic criteria is developed yet. A criteria list have been established by United States Centers for Disease Control and Prevention (CDC) for epidemiologic studies on Staphylococcal TSS, mean that a patient can not be excluded from disease based on the absence of one of these criterias when it come to diagnosis terms. This criteria list means that a confirmed case is someone who has fever >38.9°C, hypotension, diffuse erythroderma, desquamation (unless the patient dies before desquamation can occur), and involvement of at least three organ systems. If a patient misses one of these criterias, the case may be considered as a probable case.[1]
An illness with the following clinical manifestations:
- Fever: temperature greater than or equal to 102.0°F (greater than or equal to 38.9°C)
- Rash: diffuse macular erythroderma
- Desquamation: 1-2 weeks after onset of rash
- Hypotension: systolic blood pressure less than or equal to 90 mm Hg for adults or less than fifth percentile by age for children aged less than 16 years
- Multisystem involvement (three or more of the following organ systems):
- Gastrointestinal: vomiting or diarrhea at onset of illness
- Muscular: severe myalgia or creatine phosphokinase level at least twice the upper limit of normal
- Mucous membrane: vaginal, oropharyngeal, or conjunctival hyperemia
- Renal: blood urea nitrogen or creatinine at least twice the upper limit of normal for laboratory or urinary sediment with pyuria (greater than or equal to 5 leukocytes per high-power field) in the absence of urinary tract infection
- Hepatic: total bilirubin, alanine aminotransferase enzyme, or asparate aminotransferase enzyme levels at least twice the upper limit of normal for laboratory
- Hematologic: platelets less than 100,000/mm3
- Central nervous system: disorientation or alterations in consciousness without focal neurologic signs when fever and hypotension are absent[2][3].
Laboratory Criteria for Diagnosis
Negative results on the following tests, if obtained:
- Blood or cerebrospinal fluid cultures blood culture may be positive for Staphylococcus aureus)
- Negative serologies for Rocky Mountain spotted fever, leptospirosis, or measles
Case Classification
- Probable: A case which meets the laboratory criteria and in which four of the five clinical criteria described above are present
- Confirmed: A case which meets the laboratory criteria and in which all five of the clinical criteria described above are present, including desquamation, unless the patient dies before desquamation occurshttps[4]
References
- ↑ Tofte RW, Williams DN (1981). "Toxic shock syndrome. Evidence of a broad clinical spectrum". JAMA. 246 (19): 2163–7. PMID 7289007.
- ↑ cite journal |vauthors= |title=Repeat injuries in an inner city population--Philadelphia, 1987-1988 |journal=MMWR Morb. Mortal. Wkly. Rep. |volume=39 |issue=1 |pages=1–3 |year=1990 |pmid=2294395 |doi= |url=}}
- ↑ "Case definitions for infectious conditions under public health surveillance. Centers for Disease Control and Prevention". MMWR Recomm Rep. 46 (RR-10): 1–55. 1997. PMID 9148133.
- ↑ "Toxic Shock Syndrome (Other Than Streptococcal) | 2011 Case Definition".