McAllister R M, Mercer N S, Morgan B D, Sanders R
R.A.F.T. Department of Research, Mount Vernon Hospital NHS Trust, Northwood, Middlesex, UK.
Burns. 1993 Feb;19(1):22-5. doi: 10.1016/0305-4179(93)90096-q.
The features of toxic shock syndrome in burned children have been described in a review of seven patients (J. D. Frame et al., Burns 1985; 11, 234). These include a 'prodromal' 24-48 h period with diarrhoea, vomiting, general malaise, pyrexia, tachycardia and tachypnoea. The white cell count and haemoglobin concentration fall prior to the 'shock' phase, which occurs 3-4 days postburn. Once 'shock' has occurred the mortality of the condition is approximately 50 per cent; in the absence of 'shock' it is much reduced. We have undertaken a retrospective review of six burned children who were admitted in a 2-year period to the Mount Vernon NHS Trust Burns Unit with a clinical diagnosis of toxic shock syndrome. The evidence from our patients suggests that reliable early diagnostic signs are a rapidly developing severe pyrexia of 39.5 degrees C or above, and a simultaneously increasing tachycardia and tachypnoea to high levels. There is a sudden profound fall in the white cell count and haemoglobin concentration over a period of hours between 1 and 3 days from injury. Specific treatment should be instituted before the onset of 'shock'. The name staphylococcal toxaemia might promote earlier diagnosis and treatment of this condition and so reduce its mortality.
一篇对7名患者的综述描述了烧伤儿童中毒性休克综合征的特征（J.D.弗雷姆等人，《烧伤》，1985年；11卷，第234页）。这些特征包括一个为期24至48小时的“前驱期”，伴有腹泻、呕吐、全身不适、发热、心动过速和呼吸急促。在烧伤后3至4天出现的“休克”阶段之前，白细胞计数和血红蛋白浓度会下降。一旦发生“休克”，该病的死亡率约为50%；若无“休克”发生，死亡率则会大幅降低。我们对2年内入住弗农山国民保健服务信托基金烧伤科且临床诊断为中毒性休克综合征的6名烧伤儿童进行了回顾性研究。我们患者的证据表明，可靠的早期诊断体征是迅速出现的39.5摄氏度或以上的高热，以及同时出现的心动过速和呼吸急促加剧至高水平。在受伤后1至3天内的数小时内，白细胞计数和血红蛋白浓度会突然大幅下降。应在“休克”发作前开始进行特异性治疗。葡萄球菌性毒血症这个名称可能会促进对该病的早期诊断和治疗，从而降低其死亡率。
