Toxic shock syndrome physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Physical Examination

Vital Signs

• Hypotension: systolic blood pressure of ≤90 mmHg for adults or less than fifth percentile by age for children <16 years of age, which may be unresponsive to fluid infusion even large amounts of isotonic intravenous fluids
• Fever
• Tachycardia (as a result of shock and hypotension)
• Tachypnea: may be pressent as a result of pulmonary edema secondary to shock

Neurologic and psychologic

• Cerebral edema
• Seizure activity
• Headaches, memory loss,disorientation and poor concentration ,
• Somnolence, irritability, agitation, and hallucinations
• Confusion without any focal neurological findings

Gastrointestinal

• Vomiting
• Watery Diarrhea
• Hepatic Failure: Which may present with hepatomegaly, hypoalbuminemia, non-pitting edema

Renal

• Prerenal failure: Decrease in urinary output, due to dehydration and shock
• Metabolic abnormalities related to RF such as hypocalcemia, hyponatremia, and hypophosphatemia and their related signs and symptoms

CardioPulmonary

• Pleural effusions
• Pulmonary edema
• Cardiac dysfunction

Skin and moucosa

• Diffuse pruritic maculopapular rash with palm and soles desquamation
• Erythroderma
• Superficial ulcerations that may lead to petechiae, vesicles, and bullae development
• Conjunctival-scleral hemorrhage and hyperemia of the vaginal and oropharyngeal mucosa
• Non-pitting edema
• Hair and nail loss

References

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