Toxic shock syndrome - the seven Rs of management and treatment

Amanda L Wilkins; Andrew C Steer; Pierre R Smeesters; Nigel Curtis

doi:10.1016/S0163-4453(17)30206-2

Toxic shock syndrome - the seven Rs of management and treatment

J Infect. 2017 Jun:74 Suppl 1:S147-S152. doi: 10.1016/S0163-4453(17)30206-2.

Authors

Amanda L Wilkins¹, Andrew C Steer², Pierre R Smeesters³, Nigel Curtis⁴

Affiliations

¹ Infectious Diseases Unit, The Royal Children's Hospital Melbourne, Parkville, Australia.
² Infectious Diseases Unit, The Royal Children's Hospital Melbourne, Parkville, Australia; Department of Paediatrics, The University of Melbourne, Parkville, Australia; Infectious Diseases & Microbiology and Group A Streptococcal Research Groups, Murdoch Children's Research Institute, Parkville, Australia; Centre for International Child Health, University of Melbourne, Melbourne, Australia.
³ Centre for International Child Health, University of Melbourne, Melbourne, Australia; Paediatric Department, Academic Children Hospital Queen Fabiola, Université Libre de Bruxelles, Brussels, Belgium; Molecular Bacteriology Laboratory, Université Libre de Bruxelles, Brussels, Belgium.
⁴ Infectious Diseases Unit, The Royal Children's Hospital Melbourne, Parkville, Australia; Department of Paediatrics, The University of Melbourne, Parkville, Australia; Infectious Diseases & Microbiology and Group A Streptococcal Research Groups, Murdoch Children's Research Institute, Parkville, Australia. Electronic address: nigel.curtis@rch.org.au.

PMID: 28646955
DOI: 10.1016/S0163-4453(17)30206-2

Abstract

Staphylococcal and streptococcal toxic shock syndrome (TSS) are associated with significant morbidity and mortality. There has been considerable progress in understanding the pathophysiology and delineating optimal management and treatment. This article reviews the management of TSS, outlining the 'Seven Rs of Managing and Treating TSS': Recognition, Resuscitation, Removal of source of infection, Rational choice of antibiotics, Role of adjunctive treatment (clindamycin and intravenous immunoglobulin), Review of progress and Reduce risk of secondary cases in close contacts.

Keywords: Clindamycin; Contact prophylaxis; Intravenous immunoglobulin; Staphylococcus aureus; Streptococcus pyogenes; Superantigen.

Publication types

Review

MeSH terms

Disease Management*
Humans
Shock, Septic / diagnosis*
Shock, Septic / therapy*
Staphylococcal Infections / complications*
Streptococcal Infections / complications*