Toxic Shock Syndrome, 2012
In 2012, 8 cases of suspect or probable staphylococcal toxic shock syndrome (TSS) were reported. Of the reported cases, all were female and the median age was 14 years (range, 13 to 16 years). One case was associated with a wound infection, 6 were menstrual- associated with tampon use, and 1 was unknown. Staphylococcal toxic shock syndrome with isolate submission (if isolated) is reportable to MDH within 1 working day. We use the 2011 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), 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 aspartate 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 or cerebrospinal fluid cultures (blood culture may be positive for Staphylococcus aureus) or negative serologies for Rocky Mountain spotted fever, leptospirosis, or measles (if done).