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Clin Infect Dis. 2001 May 15;32(10):1470-9. Epub 2001 Apr 18.

Recurrent nonmenstrual toxic shock syndrome: clinical manifestations, diagnosis, and treatment.

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1
Infectious Disease Section, Department of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756, USA. mary-margaret.andrews@hitchcock.org

Abstract

We report 3 cases of recurrent nonmenstrual toxic shock syndrome (TSS) and review the clinical manifestations, diagnosis, and treatment. The primary sites of infection were the genital tract (in a patient who underwent cesarean delivery), the upper respiratory tract, and a breast abscess. In all 3 patients, the initial illness was not recognized to be TSS; only after development of recurrent illness with desquamation was this diagnosis entertained. Strains of Staphylococcus aureus that were isolated from 2 patients produced TSS toxin-1, whereas the third strain produced staphylococcal enterotoxin B. All 3 patients lacked antibody to the implicated toxins at the time of presentation with recurrent illness. Nonmenstrual TSS can occur in a variety of clinical settings and may be recurrent. The presence of desquamation during a febrile, multisystem illness could suggest this diagnosis and should prompt the clinician to obtain appropriate cultures for S. aureus.

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PMID:
11317249
DOI:
10.1086/320170
[Indexed for MEDLINE]

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