Toxic Shock Syndrome, 2013

In 2013, 14 cases of suspect, probable, or confirmed staphylococcal toxic shock syndrome (TSS) were reported. Of the reported cases, 64% (9/14) were female, and the median age was 14 years (range, 1 to 57 years). Five cases were menstrual-associated with tampon use, 3 were associated with wound infection, 1 was post-partum, 1 was associated with pneumonia, and 4 were 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).

• class="small">For up to date information see>> Reporting Toxic Shock Syndrome
• Full issue>> Annual Summary of Communicable Diseases Reported to the Minnesota Department of Health, 2013