Toxic Shock Syndrome (TSS), 2014

In 2014, 13 cases of suspect, probable, or confirmed staphylococcal toxic shock syndrome (TSS) were reported. Eight cases were female; the median age was 15 years (range, 9 to 72 years). Five cases were associated with tampon use. Two cases were associated with pneumonia, 1 of which was also menstrual associated. Three cases were fatal.

Staphylococcal toxic shock syndrome is reportable within 1 working day and includes submission of clinical isolates. The 2011 CDC case definition is used to classify cases. This definition encompasses the following clinical and laboratory findings: 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 creatinine 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).

• For up to date information see>> Toxic Shock Syndrome
• Full issue>> Annual Summary of Communicable Diseases Reported to the Minnesota Department of Health, 2014