Toxic Shock Syndrome (TSS) | Figure 4.8
A: Toxic shock syndrome
(Reprint from Morgan MB,
Smoller BR, Somach SC.
Deadly Dermatologic Diseases.
New York, NY: Springer; 2007)
B: Carbuncle
C: Abscess |
(Figure 4.8A) - Multisystem illness due to S.aureus, initially in women with use of superabsorbent tampons, but now more commonly seen in infections with wounds, catheters, deep abscesses, or nasal packing
- Superantigen-mediated TSST-1 results in polyclonal T-cell activation → cytokine storm (TNF, IL-1, etc)
- Presentation:
- Four criteria: fever, hypotension, macular exanthem, and involvement of three or more organ systems
- Exanthem: diffuse scarlatiniform exanthem on trunk spreading outward, palmoplantar edema, and erythema (with desquamation 1–3 weeks later), hyperemia of conjunctiva
- Treatment: remove any nidus of infection, parenteral β-lactamase resistant antibiotic, and fluid support
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