Toxic shock syndrome diagnostic criteria
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]}
Diagnostic Criteria
The diagnosis is dependent upon which organism is responsible for the TSS:
Staphylococcal TSS
The diagnosis of 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:
- Fever: Temperature ≥38.9°C (102.0°F)
- Serologic tests for Rocky Mountain spotted fever, leptospirosis, or measles
- Hypotension: Systolic blood pressure ≤90 mmHg for adults or less than 5th percentile by age for children <16 years of age
- Diffuse macular erythroderma
- Desquamation: 1 to 2 weeks after onset of illness, particularly involving palms and soles
- Multisystem involvement (3 or more of the following organ systems)
- Gastrointestinal: Vomiting or diarrhea at onset of illness
- Muscular: Severe myalgia or creatine phosphokinase elevation >2 times the upper limit of normal
- Mucous membranes: Vaginal, oropharyngeal, or conjunctival hyperemia
- Renal: Blood urea nitrogen or serum creatinine >2 times the upper limit of normal or pyuria (>5 white blood count/high power field) in the absence of urinary tract infection
- Hepatic: Bilirubin or transaminases >2 times the upper limit of normal
- Hematologic: Platelets <100,000/microL
- Central nervous system: Disorientation or alterations in consciousness without focal neurologic signs in the absence of fever and hypotension
- Negative results on the following tests, if obtained: Blood or cerebrospinal fluid cultures for another pathogen (blood cultures may be positive for Staphylococcus aureus)[1],[2]
This criteria list by CDC 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.[3]
References
- ↑ 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.
- ↑ Tofte RW, Williams DN (1981). "Toxic shock syndrome. Evidence of a broad clinical spectrum". JAMA. 246 (19): 2163–7. PMID 7289007.