Infections (1)

Question 1

Toxic Shock Syndrome:
What is this?

What’s its pathophysiology?

What is it often associated with?

What are its risk factors?

Answer 1

➊ Rare, but life-threatening infection caused by either Staph or Strep bacteria

➋ The exotoxin it releases acts as a superantigen, causing a huge immune response, leading to shock and multi-organ failure

➌ Super-absorbable tampon use in young women

➍ • Tampon use – Particularly when left in for an extended period of time, or are super-absorbent
• Female barrier contraceptive i.e. diaphragm or cap
• Childbirth
• Break in skin
• Pre-existing staph or strep infection e.g. strep throat, impetigo, cellulitis

Question 2

How does it present?

Answer 2

• Symptoms start suddenly and get worse very quickly
• Initial flu-like symptoms w/nausea, vomiting, and diarrhoea
• Rapid progression to high-grade fever and widespread, macular rash
• Multi-organ failure, w/hypotension and confusion

Question 3

Which investigations should be done?

How should it be managed?

Answer 3

➊ • Sepsis 6
• Swabs of suspected initial site of infection

➋ • Urgent admission
• A-E
• Manage as appropriate