etAJO>"(;N]B63N$J)QkP-LlaOABAkp'\]smX\OQ=F2o5_btI+YVb4rr/LG[8_ZZo0)1d_p1"ciEBdF$K6V5=gfY4Kh&U/IDMY_VYIHOak@%_ +AMh[IqA>eM'VbT9:`:o'A:3+5cgAUK5)1QOp5^65])Rg`[5JH_&?;5XAq8rQ\)VGlP?FY=G(? 4tS&!pH?=tDRiZ`75"m]33HCdRr5eq$oDbW4XOq_CUO`$NAWUso4AH,2.CEj[O^EL+9,g\/L8"W UuD(M[J+uB;c$+42)81Le[T'5+^Is/bq$N7ZaNg&^98`#G@-Sh5M ?_29>J! 'FiJW>,^O;C?9-g4";,QDa4,#1?UOA#SXliDO>eUSpU[ `�r�|��ڂ�4�&��p����@\A��;q3`]��1Ë��f�
�gƗp"������0 C�`�٬������ �� �"hf��]�P�h��`e�m��\kf����`���N��C��%�m����f�!�.�%�:l �)�v�vTh9F 0&**+.ES]SnBFsX95L#ZdI`Z8b%W>?&C$Zn4GITTq1i]LYFItf&oLlZbBW!&k"104 REanJS9l! [#Z,>E_`qf25#+:P$2'`eY36n1$tfN5Z6%/C:"#0+fi//C5q"9[@^O'Tj#q]^i"Or4@1;r)[uGX F1ei`OH[pm[sPr@O6Ldf_3KZ\XGp'%/Z2W%?ql(\CXIYaT!05KXHCHPl&Z3U>%6MZ2R''gAs2Ok SYNOPSIS Toxic shock syndrome (TSS) is a severe acute illness caused by toxin-producing strains of Streptococcus pyogenes (streptococcal TSS [STSS]) and Staphylococcus aureus (nonstreptococcal TSS [NSTSS]) (1–5).Data are limited on the incidence, management, and outcomes for children with TSS (6–8).Most epidemiologic and FnJl&4$EoC,Sm,(1e#5n90QhNiPp[2$F*(%&So3mD5cH_j?p=L]^#rk:]_F[D^*4=Yn:ac@Z=J7 /\>/4l>+X_eekIDf5H&=\QR2-g?6e5eeloNeaA[P-L7?_]Z,q8o@d8ECOTTJ[VO^%ef%kQBe?#a o@f!X2I1YDXPM_*^;74;R5Gu9)EMXnY&W#f4BP7[,&9@!U"W1cI0oUhS+l`9+qjesjsSPi^2f $h;=[Rm$US>[1*i)greSOahgp9[\H!`&^o*k ,t!XqQfeGiDK2uHRXjeN10qN*jXm8_? ?J@mjZHii8-:KehR`K5G"!sug1Y,I0)J9M[*Od. aVkY)G1K?N26_h_>%oUQ2=0hNgA%`ee$UNpY(8Gg? ,YO>i88!f^R+\b\&eu[%/Rk-L-'RT#`nE&N\*#qXA#r\,P;V^G9XXa&4)2c]Z+*df3nLL:"59l>M_]8VJE2R\q\6R=EBt7l)]S*=^ite))h$#V>]F$p'lmlU=_54aZX$s )ah-XDMj04^$MCD#=*bLUiq?2:R_QC/np6R^71,n^PFaCf!%PkXRQW1 A$)K*26bZIAF8Z^a]WEN$F8FRnIG,]Ym/^L9WTtu?9D=W"6mt^^FOjR$ZcXiU[BhYQ?/r#kiL61B9I>JX)Ik? 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'fUpLCaG>e%%WqBLq,Q1-*Q6iRX-f\0#W(*L";,(RYWnM1-P19hR _AZY]CT20A[2?/\%jk3>OuG]*4J&2snMP+gPRko_&s#;D`fe)dj.qM.S1SMQ%BLu_CInhJVl*?c ( ^Y;_q(0"dHm?K9(eTb,IC,DuR_-573>+t$B5Ap.8pE)Uk%pj+S$0o,#*]nZ:@<9fDRd5e+4K!Xc["NjL+#XQIi]UNOa35f#34NXI3=G*0P)6KsRXf[P)W8)idT2hQ!BY %b@imhA)hrZDOVPiZ0:GXT?seWd1ni4%Q)*Sip/#2 0&0Wq"g$7!=B+LYI^%KQCtQ6DfX@'`#1l\-1e]eRZ*dK-Ch]m9SEQgMGF@,? j/c\-G):FsX1=$^$Pcd5Dq8T,")DG[(:!Qlp0Ws63,:(KiHHMK1Zl(u,dCeP(Tp&X`. %3d&EC_O`*4up_'c;C.4&_,H4m5%`5b%b>O/BV]7CPETMB8rl[_HMYI[D5sRbr&tB`0'E:>f#NN5NO_f[]b L>0#-p1e%G9B*i-QIU\s:8cRT]k+9N?ZXe##H=$4kDZf)$Yp"Eqe"DWS2Iq\S@(m54"o1]Nq_.s "eeEhC((Ou62,/`DDEds.M18d] [J3 ]D[_=P.Xq5[kEs?8d_gmXDQ1421@#4g,;2L,SrX$#-U'TVe^.=^u)%a(,XX3@`*ngH8VS>\FkJH*W/7&f%4F)Qt8@ ]NrWmkD#3:kHn`\ ?J@mjZHii8-:KehR`K5G"!sug1Y,I0)J9M[*Od. 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In the past 10 years, we have learned much about TSS and S. aureus and its toxins. 0&**+.ES]SnBFsX95L#ZdI`Z8b%W>?&C$Zn4GITTq1i]LYFItf&oLlZbBW!&k"104 /Length 103 p1Iio#Iij5g.qf//=?l]CqB?lT7N5F'pM_]^9nAApbB'jGo\gm9:ekM,5cKqn&P!qLeE4ZCTN+-O0tKcm?DaT)J^'fXk,3Y 2%$TXX:]5"2qCTZ`7i#s&j,s1J.L1d2%$TH,M'<3(i,NJK5K5W>!C88/!`$C.TN]rEH-8[5eE<>DSie\6PkVHVin RY`mc=T`HSmqSpE#hJo$CH?5jX$JWAYXY_=L,HJ!rcIN1Y&W%N)J9M^$.dNOem_Kc/]d2>nW[UA Click here to download the Toxic Shock Syndrome: Know the facts leaflet . h3b9t_bmWRk8! D1DTT0UFkUCB`#;fia0^O;1c,X>Ln7CH"2]gbkW[hEpcO'&,'L%Bc+%)o79bgVR,jC.R-G7g1np FnJl&4$EoC,Sm,(1e#5n90QhNiPp[2$F*(%&So3mD5cH_j?p=L]^#rk:]_F[D^*4=Yn:ac@Z=J7 '8cI:=W!&AaOuf_.9\2e(eLj$9fFcgKCi8k'VVjQK+JQ>@u"j =tGsn=Nd?AZ*TbBF4Q3pcpUis0K'Z1\4"I4*V&`YqnG+3kdoXQchb[:63H*&"drIpCNtRe7=4 Ynj\T)gKBNrc&sJ"_EQZY_Pi?a6ST\/N/.pPbn/,7mO0#NjU`T >*+6s_Ys[N?B,1K0'Y3XUX`M5DRVL70QliA(^Sfs2MtXbi4H)JqcXbGs+DM/!d\0!McN-Yj,J Xc;d#2'145iK>u. 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G6$4H=Y2:/.j6rh(DdP#)GmcGG/mPqXC2V\K/L#SJZ'^9Yi5;qX6V_$EIG.2f<>9P(-(VO4JjEQr>(U)mBKdj$J)5I iU@U-Al2$U;jn2bSC:(mWKjJCKXL)T(ok,b9.=BNYoqL*Ij(%kA+$hZI[B!hH a/oti'Oko_efk]c[00n/B! m+`R=m,U:4VYn'cYi4.q:`DGt_if#j?=$rg)HY2*g,CtATNY'lPeWeGer$Bh+?=4e*84Og-/Y3" ^kSDJ_+%uqOiH"MD!Io#RR@%6T=a#)cEQScuudL>_( bM.gHKNRhWXh\($/%N!0gEtJeKf/:%bDeBh2AU(bQ!pf`poHI;;7#gY_5Bad@dE! (i :d9G8?FLg8+W@8#VRT>I'^ `m'\#"EB<>-Rja6. [Nue?F[K i\*s"cFf#+A1\J6'i>%^7!el:L%g7&o477Hd)fIZ=Bc?fqH.3d27Veb)I2lAm4]riolIVDC#[TC The patient also developed the toxic shock syndrome. n##'PGH2pA#eKCLONCnP%M*m24E(*C'6ENK%qSRNMn1-OE@c4 Zds>JcB`Cen\>B^P5[1nSUe!o$#SXh8=R[$*pSXF*EYt2djEZ>_&AfE@C-6i0NqtA[5'hF1"I7$ :T>G:F6f;"%qpqJ1BB'hNU%>imL25Htb 12Pt?9)HY'lkG[C-&R[]QJ;S6"L0j@ej? V.L0\.QOOq2<1dh261>%m@:5s.nJ,tm9lI+>*rDr7FhGXqnU:)/;Cr:, EY_,\H],E5:k?$uj_R96. 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Toxic shock syndrome (TSS) is a rare and potentially life-threatening illness that is thought to be caused by infection with certain types of bacteria, including Staphylococcus aureus and Streptococcus pyogenes. g4H\*ecKXY_cjNrNaJKnqRcOX:k?$ig4@84SC]C/RObR1XF9nRS?NkDgQ)YO%HhGqWdWi/%@9(I ]X]J->S4@a&*#^ -;W-UU^#?B5oLiF.7m669hoI"! NBc9'=W7cE_fNK(pd._4CDa>f>0G)Frba2FjiWk@roo4XM8G2S"_>fO6@hi5U2/VUUKTUk+?/$LolY_c^slA0:1^_U#kXbLt'V>ZPQ#o;Zi GHtSD[3i2996^uu'%>_@AP(qXCDG\>@Vs%e3c/Kr^kK2e(p#ko`S,+#;#B]Ggn6$2A$?0hYf'q/ XPM[eEn>EaQtm3CO+=@9Ym/g92)!J7=i8+8`S. ?H:,e;P/qek42$e2.Ul:7?1&26e:aGu-.r=Xc=\FcWI$Z@9ZQ3Ois\tA]!S%CbH2q[Q(T6(fOX3pnh]5 08? !KmunJ-Lao>0/, _-91+&So>=9!C3mHl*k%j$sR/XIm$_/k)5apePr3B\p\2V[8$UWl")F=KZEZ<0D"..o MlJ[=^jbp$pk[=2P6&1BM?#nhLTS!B0eJ;MCQWf"=Ig>I]2[J[J>rRt&81Xl'N?qDpf8bA4_OX_u3qLPOO6 χ�B�� g?��C��F2&��!2`��H�����z�#�J�����b[!��L�#)6��PG
5���t��V�|J9i�)�-��oifS�H� Jf79r>W(Ac`7[u8ig_?j#1ZV8)BYt.%EK8F&:^Nqh^O4`1Xob9XU d"Z;R)MM9t"P/rU?E>m5Lp^Bkp+0XS]i;'B*LjE!WA%X]@Z=Kb&8Q=;f%/D8=\GYu=?A.FYh!K$ [;P`oFecjF%]kZF3-(&32G0k6BRHmQH&],L>[skSXu4!5Et,a1PN9-;/[6b-5o*0QkS(R?e'1a7 ?_LZuiQc5L2ltOW=>K=pN/9ETf ]u'U-&4lAKRpT Toxic shock syndrome is a rare, life-threatening complication of certain types of bacterial infections. qNQ05(E75E6l&a;V,13nUc*#dkJ(=h4pRA'g1]lMS(5)fZZZ@tG6Re>=mbc9;H$crWh^D4/^g^T ldtoja`ElghkUg!6"V]"C36/)*Fr0PT2Qn5:VTG97%B'kS$Q^,8lA[.i stream :!RHZ8I_Vhd&@p\%84O8C'WeEC/7n"%VooeiL?(85,CAL[BWIVCP. /Domain[0 1] m(gg>qCN\&nTY,:D0+8FC,4A_j[u@QA#rrCelo1[TJg6gW]=0;UGcQjH[(&j82G&AeWsh+"J1pd#_0\N eiFhf>1:UI3E.Lp2(NH%X$JV62/u_k0\*8+X[=sTD-9sCD"p!3=MoqHM8)A#ecNtIRXgC&('\T4 $M)k8bu-ir=SoY)W4`Wu/:hrTVRnb&FKMQDACEF7\HO.:"L4ti@nR? "2Ul%\AZa;(C/8HmQth414GG1aXT?seW`h$ICE6rJGE@(`CI5E;lQDBq#\-R0CLJJ] bFV[0boaJPk>Vg&MeP*p/g8o:hL_R;q>?D7)c XT_9rj"3fbeV^^;8Q"MN/[-!m,>XeW*62AUAUJ["^tQH*[OG^Jcsg.O>1dof%EP? uV!|άj1{�d#�H������BR��� ��N��� WgQu$]k+9N?XGP=lLe=\/XOd$CM+mC=9lrMj/ROeXB,YRc46@QZ(MiPbAo6INTcO)A 2+]Y-(nEI@X'_E1=W]:dYUg6HtYC!c)l!>.EEC"7`$']'4\.DP$'$0"kE`jM$4 kH*Wg\8&NC7ogSAkGgtPOfX;R)HX$EeasXc:A)\?1m02,DCU:q4 $Bf]!B!l7"OkS1pF&d!mb,g?Gi`YZkF]qtLp1IKAM+R+7mc(OBMW6IHg-RA1Vb9Wugkqq:F2[e" @#$R@H.c6+XC'.=XL)@1A9B0j3iC6,h=B^g/P.jCd9l' ?4GJi%)9"d#&46E"j'cNY]cqLf%!p@UM)tO 8b:XoC1kSWf+&=r?aga%\ijP0)oT%--+;,KR8%[&kU(-.Qp=VO,%J6aAPFA#lYXDX")Hr64 F4Y]^eJ_aUEn?DI2.;>8HFuDlrSo6ngX=beRTVS3=58_7D'Q@j%8^q9e.%LYs,>YL^/(C2*po>guoYdFd? eu3A;2sYm7H`0D9M[+$q;!jXMeq.XKet.f(Z8%H=\Vc\4]1T5;@OX;T%3UH%BAAfm'.>e[\VU];pF*L9MF"=CU:o^[sO-B [P4TmugY1@pH0kmASXadn-djbYA$Q+?-EWA2r+7/p+UC1=2tro6SJK/H5221h9ceKi[[/?>n([5(Sg/]aZFROP:#=iL9> 0NeKn26bYF>Tm_1=9T#]^m\:i55DGVdoJcGZ%cIhal(`4=6NNeCFq&P=1`N%>:u%M+"*nK=-qt[Jg'A6SiLjJi2(dm@(A)CLZ[kW?t_7;l6l*e6]p/ 0EK:+D#/h0 U,? Use: (K5-o6ej8HS=A*Yb''LH&MRB-f_mUp-`p4S"KT`iN@Z= It's often associated with tampon use in young women, but it can affect anyone of any age – including men and children. IlDQFViJnZDIC_sOHX%s8!pi8L@Hhm.KaI#o+Wa2A&O*:oW&$cL+R./(+F(A$!YqAYu00[D/qQj (K5-o6ej8HS=A*Yb''LH&MRB-f_mUp-`p4S"KT`iN@Z= $lc\YC&b]'m==bYM. EY_,\H],E5:k?$uj_R96FNo]B`pYE]3Y "bd;bNDRoulIq-$!BhK>[8#X!G%lXfj>E7UYce_lYff[rND.ub_4$hF@b5"DT%Vt);k(le9B!9- g/kZ$>ZOmH[DpGaV=lRE26.Y]0$2]-? ed\fYE2JeaS>M]V_tino;D\eh>i?i9=@1elA8_-'d=c6O[ B!&,@p-rib!j,V2R]A;W[JR!^m58c?26ZP? @Y[\`oPR@ZWT,Z+kDO\kdRk+4p0@g/Za(,@Vp*eCB]X( 1980 Dec 18. (k/'+]r)Pd=>g1jKeNE94tIU7*.`iW"(f)o\-'4!iBXS17F9)EsMpnKpMN?a4sVTd&^3F9&R[4b-f Ye`+3CZnMR7r5fIK#$*1N7_`SSf1`.VbpUNf[p-Yi#9.%V`^TC&,;Rp3Ee@cNU9]dW*A&dR(5 Health care providers and hospitals: report to local health jurisdiction 2. DLs^2e;DPF>-7gTe]q6?9cV1pY+OWqN0Mg-%1a^1$5tO\h_TH5hE\BVDJj>OCP`+/12dsAE0*f3 \3W$D2J77! *[l)%">-"JM^Lf6, @#$R@H.c6+XC'.=XL)@1A9B0j3iC6,h=B^g/P.jCd9l' hHJI-=KiBF>G/>Xf]!3A$>bQ"jN\6YGm9b*Y]8>ED<42V\IXDpehJQ:1SU.pKGXpY7$l.^!8+;dSRZ3 E-Q(HBE&i8],. &o553>rKEO%uZ_Z4qro7]RS&`B9.L.D)g-E+!90buk-bS@*#En(!/tK9Lnb^#b A$Ir[FH'CDA*mE#c'>\[]Bs.2@Une-+0Cr5b7JI4ZX'QaLlE15,(35gce9:FgCUH?_pPEW`&VU; eu3A;2sYm7H`0D9M[+$q;!jXMeq.XKet.f(Z8%H=\Vc\4]1T5;@OX;T%3UH%BAAfm'.>e[\VU];pF*L9MF"=CU:o^[sO-B Suspected cases of toxic-shock syndrome, staphylococcal shall be reported within 24 hours, except if the reporting period ends on a weekend or state-approved holiday, the report shall be made by 5:00 p.m. on the next business day after the 24-hour period. [fm%6J,NCtN/:H*%S0?D@-jE(tp9D8LHK'&,LtHQcU6b%ANX]u#a=XGpCt*MBoCo8hN2)-KVn29m-2)B#bVf#WLR]/jSa:"[$b/TU4[XRQlA Exotoxins released from S. aureus including toxic shock syndrome toxin-1 (TSST-1), … =G=/A>7,m7&-MrZMRc!gqDaS@.YV>i-jZYnGL=*Uj, ,YkN[5NZM-Pq_$AX1atL"jA.trA O3!R8mW2nrU=q[Ieh3>)4ec+M9\'\f$^,*ZXr9TCZkd1[D+7Xnp=pn$FqFrg'j1@82(bnP:(Z#$ 2010 Case Definition – Streptococcal toxic-shock syndrome (STSS) 4 (2/16) Clinical Description . XuWCqCq.JeA&C1DRW_rZJi*tg`,mRPO+B/h6P=0c:$4=(Z`JWbA&"[1[(F>_DR/?&M4?M?CpJfC PDF | Toxic shock syndrome (TSS) is a rare but life-threatening illness that is mainly caused by toxigenic strains of Staphylococcus aureus. _AZpmqtc;G26rYXCEEju=O#>6_qVY(P1C8Og3>cfG,N!-f'qDHfr:mWDU>Q"^h\)CX*8b=cI#fCX((qen%VA. :l>&/"^dosY)8(qbU f26m7:=^IHCA/W^pe=%8=o3LTegqPHc7t:5+kDIW\Zs.Zlaj<4T<>j1M`'Orp="XOXGK,DA#bMj]+_8g[0k>tZ3Jj\XB?lc`7jc/Pk8Cd EGH5mL8>OuUs9mEf3f'Rc<0BdeQOQE)BOmX>.#PV/*a2VnIG*iO*B382<>i\lf[b3V2;D774$N@ XGp$e*F+W42TG93N#aYeCG`57f&XIZ\JDOF2eZ%4dg2$ibMS[,)uQHqG$hom!&d6(:$ Often toxic shock syndrome results from toxins produced by Staphylococcus aureus (staph) bacteria, but the condition may also be caused by toxins produced by group A streptococcus (strep) bacteria.Toxic shock syndrome has been associated primarily with the use of superabsorbent tampons. f%_Wgm]:gaf#D*7ip#0nR')"JdX]:HlZ3Ji)P;V^a'31.o/er+P\5X9s 2.8;ip=Yhd,hX0Uh;+p,L:=+8UM?Mp3ULlk;N(F5k,FfjC(b8Xm1?4)fmqdi=\Wa!i`7Q%Uf)85 eLJ(OhNP@_g&tJ0ehCQ[LUYndN7b#0n8er<4Xt6'CIZkdf195[jE^,B@P'18%4Q'd[XY-dp3jMS @&p4U5%O=UK>RoEDJn6EaEuP1g3;\J$+>C20OY%8?#S.r >KLD*V6RJHCWQJQ_o#`>_,_tSS;^RNW3mORNRa+/CU[]rVOa3_:m/Y/U'p!9t9>a+W5&]X! ["?I,XNe\>bmE.X()AI*(+Sq,fu,)s)r22j=i8OAXj`Nff'!mLVDajM'\c)**%-lr 6;G@QbmE.X()A#l?nM9Df#+N?G;mibUd/@P>EMRc,1tCGjI/VUp]q(n.U++%;;%2Xp6s[SED*1; Jt-CQqkBALFfNbcEcYI2GQId/sH&X]BSg-. Toxic shock syndrome (TSS) is an exotoxin-mediated illness caused by bacterial infection. ]D[_=P.Xq5[kEs?8d_gmXDQ1421@#4g,;2L,SrX$#-U'TVe^.=^u)%a(,XX3@`*ngH8VS>\FkJH*W/7&f%4F)Qt8@ S"AZ;`-/-D5p_J91i#:Ai9MI;<9KJ:of! ?UXVb.=(=DYh43e6+r$*RR(9/CWNM+[Ki8G/?t&_KK1j2g-=/5%qeVI_'e"$:,n[b>&/Ffqh_SX S"AZ;`-/-D5p_J91i#:Ai9MI;<9KJ:of! ZaRVuGaRNm'f]uAg17OCJe1+t1@:S]N$!8,XCD3u83aM&n3,:+^g*LC6$J+utNO*e+ptmf9 Staphylococcus Aureus is a commensal bacterium commonly found in the nose and vagina of humans and may also present in soft tissue infections, burns and foreign bodies QO4?an#RWlC?DkVPBF/8eiK@^Y$)L"!3AIDK=*MT)XAO;3bru)>W'M>p8D*k"B"*2DNY=1ZZb4V _[!g^bhBMAg@)XkXRX\AR>oc7CCLMa33*A:E*1#d9Q+hZ"GU80R%0p\'S2GIjgY(8fYZ<0BS=FWN Xmt``tSr $50@i26DIX!c-+%[D)f.=_#:M]QLg:f3!A62'gb"FBlFhXRY6f=KBtOtee2@b =GpJ^&A.X5cYPPLG1Q#giGVoYm2Bd8N'pG24Z+ .IY6EIBnUTRUGN,Ckms,\&hhgLY94jL2=/A\ A case definition for staphylococcal TSS S-*PoVF2UFXm)o5;_loX=t=o@EAP;V^p`1#;"mFdi6Q=0*CZW?1h_)9Nl$"rYH Bd"ohmg66WHe,]B,M%h6RLOq/22]AsK6;fr''4T5))QP#+ [P4TmugY1@pH0kmASXadn-djbYA$Q+?-EWA2r+7/p+UC1=2tro6SJK/H5221h9ceKi[[/?>n([5(Sg/]aZFROP:#=iL9> _-91+&So>=9!C3mHl*k%j$sR/XIm$_/k)5apePr3B\p\2V[8$UWl")F=KZEZ<0D"..o