Toxic Shock Syndrome, 2008
In 2008, 4 cases of suspect or probable staphylococcal toxic shock syndrome (TSS) were reported. Of the reported cases, 3 were female and the median age was 18 years (range, 11 to 38 years). Two of the 4 were menstrual-associated, 1 was wound-associated, and 1 was surgical wound-associated.
Staphylococcal toxic shock syndrome with isolate submission (if isolated) is reportable to MDH within 1 working day. MDH follows the 1997 CDC case definition which includes fever (temperature >102.0°F or 38.9°C), rash (diffuse macular erythroderma), desquamation (within 1-2 weeks after onset of illness), hypotension (SBP <90 mm Hg for adults or less than fifth percentile by age for children aged <16 years; orthostatic drop in diastolic blood pressure greater than or equal to 15 mm Hg from lying to sitting, orthostatic syncope, or orthostatic dizziness), multisystem involvement (>3 of the following: vomiting or diarrhea at onset of illness; severe myalgia or creatine phosphokinase level at least twice the upper limit of normal; vaginal, oropharyngeal, or conjunctival hyperemia; blood urea nitrogen or creatinine at least twice the upper limit of normal for laboratory or urinary sediment with pyuria (>5 leukocytes per high-power field) in the absence of urinary tract infection; total bilirubin, alanine aminotransferase enzyme, or asparate aminotransferase enzyme levels at least twice the upper limit of normal for laboratory; platelets less than 100,000/mm3; disorientation or alterations in consciousness without focal neurologic signs when fever and hypotension are absent); negative results for blood, throat, or cerebrospinal fluid cultures (blood culture may be positive for Staphylococcus aureus) or no rise in titer to Rocky Mountain spotted fever, leptospirosis, or measles (if done).