Wenisch Christoph, Strunk D, Krause R, Smolle K H
4. Med. Abt. Infektions und Tropenmedizin, SMZ-Süd KFJ Spital, Wien, Austria.
Int J Dermatol. 2007 Jun;46(6):578-82. doi: 10.1111/j.1365-4632.2007.03297.x.
diagnostic dilemma in toxic shock syndrome (TSS) is that the results of microbiologic investigations are often not available immediately because of the need for incubation, or no obvious entry point can be found.
We describe three patients with a clinical diagnosis of TSS in whom microbiologic tests were negative.
All patients had complicated courses with vasopressor-dependent shock, renal and respiratory failure, and disseminated intravascular coagulation for at least 1 week. In all three patients, diagnosis was considerably faster with the assessment of the expansion of T-cell-receptor Vbeta2-positive T cells (> 15%) than by Centers for Disease Control and Prevention (CDC) diagnosis, because of the complicated clinical picture or the delay caused by waiting for the results of microbiologic investigations.
Our results indicate that diagnostic procedures incorporating Vbeta2-positive T cells could be a useful tool for the diagnosis of TSS.
中毒性休克综合征（TSS）的诊断困境在于，由于需要培养，微生物学检查结果往往不能立即获得，或者找不到明显的感染入口。
我们描述了3例临床诊断为TSS的患者，其微生物学检查结果为阴性。
所有患者病程复杂，出现依赖血管升压药的休克、肾和呼吸衰竭以及弥散性血管内凝血至少1周。在所有3例患者中，由于临床表现复杂或等待微生物学检查结果导致延迟，通过评估T细胞受体Vβ2阳性T细胞的扩增（>15%）进行诊断比疾病控制与预防中心（CDC）的诊断要快得多。
我们的结果表明，纳入Vβ2阳性T细胞的诊断程序可能是诊断TSS的有用工具。
