Streptococcal TSS

GENERAL PRINCIPLES

Associated with invasive GABHS infections, particularly necrotizing fasciitis or myositis (80% of cases). Mortality is much higher (30%-70%) compared to staphylococcal TSS.

DIAGNOSIS

• Initial presentation is typically abrupt onset of severe diffuse or localized pain. Systemic manifestations are otherwise similar to staphylococcal TSS, but the desquamating erythroderma is much less common.

• Blood cultures are usually positive, and antistreptolysin O titers are elevated.

TREATMENT

See Table 14-1.