一种毒素介导性疾病,多为 A 族链球菌或金黄色葡萄球菌感染引起。
阅读更多首发体征和症状可为非特异性,但呈急性起病,且毒性作用较早发生,导致严重的危及生命的疾病和多器官系统衰竭。
早期诊断和治疗很关键。
链球菌中毒性休克综合征 (TSS) 可伴随任意部位的感染发生,但更常见的是皮肤感染。
葡萄球菌 TSS(经期或非经期)与卫生棉的超期使用、产后感染和其他部位的病原体感染有关。
治疗手段包括在重症监护病房 (ICU) 内的支持疗法、早期经验抗生素治疗,进一步的培养物敏感性抗生素治疗。可能需要外科清创术来治疗深部链球菌感染。
中毒性休克综合征 (TSS) 是细菌感染引起的外毒素介导的疾病。通常相关的病原体包括 A 族链球菌(化脓性链球菌),[1]Centers for Disease Control and Prevention Working Group on Severe Streptococcal Infections. Defining the group A streptococcal toxic shock syndrome: rationale and consensus definition. JAMA. 1993;269:390-391.http://www.ncbi.nlm.nih.gov/pubmed/8418347?tool=bestpractice.com[2]Centers for Disease Control and Prevention. Streptococcal toxic shock syndrome (STSS): 2010 case definition. 2010. http://www.cdc.gov (last accessed 9 January 2017).http://wwwn.cdc.gov/NNDSS/script/casedef.aspx?CondYrID=858&DatePub=1/1/2010%2012:00:00%20AM或甲氧西林敏感 (MSSA) 或抗甲氧西林 (MRSA) 金黄色葡萄球菌。[3]Centers for Disease Control and Prevention. Case definitions for infectious conditions under public health surveillance. MMWR Recomm Rep. 1997;46:1-55.http://www.cdc.gov/mmwr/preview/mmwrhtml/00047449.htmhttp://www.ncbi.nlm.nih.gov/pubmed/9148133?tool=bestpractice.com虽然首发体征和症状可为非特异性(如发热、寒战、肌痛、头痛),但其病程进展迅速,且休克和多器官系统衰竭可能在病程早期就会发生。
阅读更多葡萄球菌 TSS 可以分为 2 组:经期 TSS,发生于经期单片卫生棉或是高吸收性卫生棉的超期使用;非经期 TSS,由产后阴道和剖腹产伤口感染多种葡萄球菌引起。[4]Reingold AL, Hargrett NT, Shands KN, et al. Toxic shock syndrome surveillance in the United States, 1980 to 1981. Ann Intern Med. 1982;96:875-880.http://www.ncbi.nlm.nih.gov/pubmed/7091960?tool=bestpractice.com[5]Kotler DP, Sandkovsky U, Schlievert PM, et al. Toxic shock-like syndrome associated with staphylococcal enterocolitis in an HIV-infected man. Clin Infect Dis. 2007;44:e121-e123.http://cid.oxfordjournals.org/content/44/12/e121.longhttp://www.ncbi.nlm.nih.gov/pubmed/17516392?tool=bestpractice.com[6]Paterson MP, Hoffman EB, Roux P. Severe disseminated staphylococcal disease associated with osteitis and septic arthritis. J Bone Joint Surg Br. 1990;72:94-97.http://www.bjj.boneandjoint.org.uk/content/72-B/1/94.longhttp://www.ncbi.nlm.nih.gov/pubmed/2298804?tool=bestpractice.com[7]Ferguson MA, Todd JK. Toxic shock syndrome associated with Staphylococcus aureus sinusitis in children. J Infect Dis. 1990;161:953-955.http://www.ncbi.nlm.nih.gov/pubmed/2324544?tool=bestpractice.com[8]Parsonnet J. Nonmenstrual toxic shock syndrome: new insights into diagnosis, pathogenesis, and treatment. Curr Clin Top Infect Dis. 1996;16:1-20.http://www.ncbi.nlm.nih.gov/pubmed/8714246?tool=bestpractice.com