Gram Positive Cocci
A 28-yrs-old menstruating woman appeared in the emergency room with the following signs and symptoms: fever, 104oF; WBC, 16,000; BP, 90/65 mmHg; a scarlatiniform rash on her trunk, palms, and soles; extreme fatigue; vomiting; and diarrheA. The patient described in this case most likely has which of the following? (AIPG 2010)
|B||Guillain – Barre syndrome|
|C||Scaled skin syndrome|
|D||Toxic shock syndrome|
a. Toxic shock syndrome (TSS) is a febrile illness seen predominantly in women. Clinical criteria for TSS include fever greater than 102°F (38. rash, hypotension and abnormalities of the mucous membranes and the gastrointestinal hepatic, muscular, cardiovascular, or central nervous system.
b. Usually three or more systems are involved. Treatment is supportive, including the aggressive use of antistaphyloccal antibiotics.
c. Certain types of tampons may play a role in TSS by trapping O2 and depleting magnesium. Most people have protective antibodies to the toxic shock syndrome toxin (TSST-1) TSS is caused by a toxin strain of S. aureus (TSST-1). Vaginal colonization with S. aureus is a necessary adjunct to the disease. S. aureus is isolated from the vaginal secretions conjunctiva nose, throat, cervix, and feces in 45 to 98% of cases. The organism has infrequently been isolated from the blood.