2010-2017 年美国俄亥俄州哥伦布市儿童中毒性休克综合征的表现。
Manifestations of Toxic Shock Syndrome in Children, Columbus, Ohio, USA, 2010-2017.
出版信息
Emerg Infect Dis. 2020 Jun;26(6):1077-1083. doi: 10.3201/eid2606.190783.
Abstract
Data are limited on the incidence and management of streptococcal toxic shock syndrome (TSS) and nonstreptococcal TSS in children. We aimed to define the clinical patterns of TSS at Nationwide Children's Hospital in Ohio as they relate to published criteria, diagnostic decisions, and treatment options. Through retrospective chart reviews, we identified 58 patients with TSS (27 streptococcal, 31 nonstreptococcal) during January 2010-September 2017. We observed clinical and laboratory findings that are not part of TSS criteria, such as pyuria in streptococcal TSS (50% of patients) and pulmonary involvement (85%) and coagulopathy (92%) in nonstreptococcal TSS patients. Recommended treatment with clindamycin and intravenous immunoglobulin was delayed in streptococcal TSS patients without rash (3.37 days vs. 0.87 days in patients with rash), leading to prolonged hospitalization and complications. Incorporation of additional TSS signs and symptoms would be helpful in TSS diagnosis and management.
摘要
关于儿童链球菌中毒性休克综合征（TSS）和非链球菌 TSS 的发病率和治疗方法，相关数据有限。我们旨在根据已发表的标准、诊断决策和治疗选择，确定俄亥俄州全国儿童医院的 TSS 临床模式。通过回顾性病历审查，我们在 2010 年 1 月至 2017 年 9 月期间发现了 58 例 TSS 患者（27 例链球菌性，31 例非链球菌性）。我们观察到了一些不属于 TSS 标准的临床和实验室发现，如链球菌性 TSS 中的脓尿（50%的患者）和肺部受累（85%）以及非链球菌性 TSS 患者的凝血功能障碍（92%）。建议使用克林霉素和静脉注射免疫球蛋白治疗，但在没有皮疹的链球菌性 TSS 患者中会出现延迟（无皮疹患者为 3.37 天，有皮疹患者为 0.87 天），导致住院时间延长和并发症增加。纳入更多 TSS 症状有助于 TSS 的诊断和治疗。
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