CCase Definition of Toxic Shock SyndromeCASE DEFINITION TSS

1. Fever (temperature 38.9_ C [102_ F])

2. Rash characterized by diffuse macular erythroderma

3. Desquamation occurring 1-2 wk after onset of illness (insurvivors)

4. Hypotension (systolic blood pressure _ 90 mm Hg in adults) ororthostatic syncope

5. Involvement of three or more of the following organ systems:a. Gastrointestinal (vomiting or diarrhea at onset of illness)

b. Muscular (myalgia or creatine phosphokinase level twicenormal)

c. Mucous membrane (vaginal, oropharyngeal, or conjunctivalhyperemia)

d. Renal (BUN or creatinine level _ twice normal or _ 5 WBCs/HPF in absence of UTI)

e. Hepatic (total bilirubin, SGOT, or SGPT twice normal level)

f. Hematologic (platelets _ 100,000/mm3)

g. Central nervous system (disorientation or alteration inconsciousness without focal neurologic signs when fever andhypotension are absent)

h. Cardiopulmonary (adult respiratory distress syndrome,pulmonary edema, new onset of second- or third-degreeheart block, myocarditis)

6. Negative throat and cerebrospinal fluid cultures (a positiveblood culture for Staphylococcus aureus does not excludea case)

7. Negative serologic test results for Rocky Mountain spottedfever, leptospirosis, rubeola