This would be the causative agent:
Challenge: What's the diagnosis?Related Questions:
1. What is seen in the Gram stain?
First image shown under fair use.
Second image shown under GNU Free Documentation License.
Friday, September 14, 2007
Reliance
A 20 year old woman is brought in by a concerned neighbor to the emergency room. The neighbor reports that she was found vomiting and confused. On exam, the patient has a temperature of 40 C (104 F) and a blood pressure of 85/50. She looks like she has a big sunburn, but as this is San Francisco, that's sort of odd. You get some labs and notice an elevated serum creatinine, AST, ALT, and a platelet count of 80,000/mm2.
This would be the causative agent:
Challenge: What's the diagnosis?
Related Questions:
1. What is seen in the Gram stain?
First image shown under fair use.
Second image shown under GNU Free Documentation License.
This would be the causative agent:Challenge: What's the diagnosis?Related Questions:
1. What is seen in the Gram stain?
First image shown under fair use.
Second image shown under GNU Free Documentation License.
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3 comments:
1. is it staph aureus? which causes scalded skin syndrome.
Reliance
The criteria for Toxic Shock Syndrome (and Toxic Shock Like Syndrome) include high fever, hypotension, a diffuse erythematous blanching (“boiled lobster”) rash, and involvement of 3 or more organ systems. Infection may occur through the vagina due to tampon use (with an increased risk with Rely tampons). The causative agent is Staphylococcus aureus which produces a superantigen toxin leading to nonspecific MHC II binding and polyclonal T-cell activation. The Gram stain shows Gram positive cocci in clusters. S. aureus is also both catalase positive and coagulase positive.
The exotin Toxic Shock Syndrome Toxin-1 (TSST-1) is a superantigen that can activate large numbers of T cells (up to 20%), resulting in massive cytokine production. They bind the invariant region of the Class II MHC. IL-1 mediates the high fever.
Sources: McKinnon and Howard, “Evaluating a Febrile Patient with a Rash,” American Family Physician, Aug 15, 2000; Wikipedia; UpToDate.
Scalded skin syndrome affects mostly children.
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