Pediatrics & Therapeutics
Open Access
ISSN: 2161-0665
+44 1478 350008
ISSN: 2161-0665
+44 1478 350008
Tania Sofia Leano Martins, Maria Jose Oliveira and Augusto Ribeiro
Centro Hospitalar Sao Joao, Portugal
Posters & Accepted Abstracts: Pediat Therapeut
Introduction: Toxic shock syndrome is an acute and multisystem entity, mediated by toxins produced by Staphylococcus aureus or Streptococcus pyogenes. The staphylococcal SCT is often associated with tampon use, loss of skin integrity and less frequently with pneumonia and empyema. Clinical Case: Female children of six year old were observed with fever (39�?°C), headache, sore throat and pruritic rash. Scarlet fever was diagnosed and treated with penicillin. Persistent fever associated with prostation was reevaluated in three days. The physical examination showed moderate hypotension and signs of dehydration. 14000 leukocytes, PCR 262 mg/L, glucose 47 mg/dL, urea 168 mg/dL and creatinine 2.17 mg/dL in 127 mEq/L were analytically presented. Clinical worsening in 24 hours with refractory hypotension to fluid therapy proceeded to intubation and started inotropic support. The erythematous rash regressed and started peeling hands. Left ankle edema with skin necrosis area found in the outer malleolus associated with flushing and floating, where small amount of liquid with isolation of Staphylococcus aureus was aspirated. Enterococcus faecalis in the first blood culture was isolated, later all blood and urine cultures were negative. She completed 14 days with ceftriaxone and clindamycin. Discussion: Toxic shock syndrome is a rare entity, with a low incidence but high mortality. The diagnosis is clinical, only 5% of blood cultures are isolated from Staphylococcus. High index of suspicion is necessary because there are numerous infectious frames that occur with fever and rash, in particular, scarlet fever, Kawasaki disease, meningococcemia and Stevens-Johnson syndrome.
Tania Sofia Leano Martins has completed her Medical Schooling from Medical School of Porto with 15 values and now is pursuing Pediatrics Specialty. She is a Trainer of advanced support of pediatric life as part of the Portuguese pediatric resuscitation group and Volunteer Teacher of pre-graduated Pediatrics practical and theory classes of Master’s degree in Medicine from Oporto Medical Schools. She has attended several courses with evaluation like 11th European Post-graduate course in Neonatal and Pediatric Intensive care. She has presented several clinical studies in national and international conferences and published in the form of book chapter themes: Tuberculosis in pediatrics age and Neutropenia in Pediatrics.