RT Book, Section
A1 Sabella, Camille
A2 Usatine, Richard P.
A2 Sabella, Camille
A2 Smith, Mindy Ann
A2 Mayeaux, E.J.
A2 Chumley, Heidi S.
A2 Appachi, Elumalai
SR Print(0)
ID 1114878811
T1 Toxic Shock Syndromes
T2 The Color Atlas of Pediatrics
YR 2015
FD 2015
PB McGraw-Hill Education
PP New York, NY
SN 978-0-07-176701-9
LK accesspediatrics.mhmedical.com/content.aspx?aid=1114878811
RD 2024/04/16
AB An  11-year-old  boy  presented  to  the  emergency  department  with  a  12-hour  history  of  fever,  rash  over  his  trunk,  vomiting,  and  diarrhea.  In  the  emergency  department,  he  had  a  fever  to  39.3ºC.,  pulse  140/minute,  respiratory  rate  40/minute,  and  blood  pressure  90/60  mm  Hg.  He  had  conjunctival  injection  and  inflamed  oral  mucus  membranes,  and  intense  erythroderma  (red  skin)  on  his  trunk  and  back  (Figure  185-1).  Laboratory  tests  revealed  thrombocytopenia,  transaminitis,  and  an  elevated  creatinine  level  that  was  twice  normal  for  his  age.  He  was  given  fluid  resuscitation  and  was  admitted  to  the  pediatric  intensive  care  unit,  where  he  required  several  fluid  boluses  and  inotropic  support  to  maintain  adequate  blood  pressure  and  perfusion.  He  was  treated  with  vancomycin  and  clindamycin.  Staphylococcus  aureus  was  isolated  from  an  infected  wound  on  his  lower  extremity  that  he  sustained  from  a  sports  injury  a  few  days  prior  to  his  presentation.