Case Definition of Staphylococcus aureus Toxic Shock Syndrome |
| Clinical Criteria |
An illness with the following clinical manifestations: - Fever: temperature ≥102.0°F (≥38.9°C)
- Rash: diffuse macular erythroderma
- Desquamation: 1-2 weeks after rash onset
- Hypotension: systolic blood pressure ≤90 mmHg for adults or less than the fifth percentile, by age, for children <16 years old
- Multisystem involvement (≥3 of the following organ systems)
- Gastrointestinal: vomiting or diarrhea at illness onset
- Muscular: severe myalgia or creatine phosphokinase level at least twice ULN
- Mucous membrane: vaginal, oropharyngeal, or conjunctival hyperemia
- Renal: blood urea nitrogen or creatinine level at least twice ULN for laboratory or urinary sediment with pyuria (≥5 leukocytes per high-power field) in the absence of urinary tract infection
- Hepatic: total bilirubin or aminotransferase level at least twice ULN for laboratory
- Hematologic: platelet count <105 /µL
- Central nervous system: disorientation or alterations in consciousness without focal neurologic signs in the absence of fever and hypotension
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| Laboratory Criteria |
Negative results in the following tests, if obtained: - Blood or cerebrospinal fluid cultures for another pathogena
- Serologic tests for Rocky Mountain spotted fever, leptospirosis, or measles
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| Case Classification |
Probable: a case that meets the laboratory criteria and in which four of the five clinical criteria are fulfilled Confirmed: a case that meets the laboratory criteria and in which all five of the clinical criteria are fulfilled, including desquamation (unless the pt dies before desquamation occurs) |