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September 1997, Vol 133, No. 9 >
Article | September 1997

Toxic-Shock Syndrome—United States

Arch Dermatol. 1997;133(9):1179-1180. doi:10.1001/archderm.1997.03890450131027
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CASES OF a newly recognized illness known as toxic-shock syndrome1 have recently been reported to CDC by state health departments in Wisconsin, Minnesota, Illinois, Utah, and Idaho. Physicians in 8 other states have reported individual cases to CDC or to investigators at the University of Colorado, Denver.

Toxic-shock syndrome typically begins suddenly with high fever, vomiting, and profuse watery diarrhea, sometimes accompanied by sore throat, headache, and myalgias. The disease progresses to hypotensive shock within 48 hours, and the patient develops a diffuse, macular, erythematous rash with nonpurulent conjunctivitis. Urine output is often decreased, and patients may be disoriented or combative. The adult respiratory distress syndrome or cardiac dysfunction may also be seen.

Laboratory studies reveal elevated blood urea nitrogen, serum creatinine, bilirubin, and creatine phosphokinase levels, and white blood cell counts with marked left shifts. Platelet counts are low in the first week of illness but are usually

REFERENCES

1 +
Todd J, Fishaut M, Kapral F, Welch T.  Toxicshock syndrome associated with phage-group-I staphylococci . Lancet 1978;;2:1116-8.
2 +
Everett ED.  Mucocutaneous lymph node syndrome (Kawasaki disease) in adults . JAMA 1979;; 242:542-3.
3 +
Schlossberg D, Kandra J, Kreiser J.  Possible Kawasaki disease in a 20-year-old woman . Arch Dermatol 1979;;115:1435-6.
4 +
Todd J, Fishaut M.  Toxic-shock syndrome associated with phage-group-I staphylococci . Lancet 1978;;2:1116-8.
5 +
Petitti DB, Reingold AL, Chin J.  The incidence of toxic shock syndrome in Northern California, 1972 through 1983 . JAMA 1986;;255:368-72.
6 +
Petitti DB, Reingold AL.  Recent trends in the incidence of toxic shock syndrome in Northern California . Am J Public Health 1991;;81:1209-11.
7 +
Todd JK, Wiesenthal AM, Ressman M, Caston SA, Hopkins RS.  Toxic shock syndrome. II. Estimated occurrence in Colorado as influenced by case ascertainment methods . Am J Epidemiol 1985;;122:857-67.
8 +
Davis JP, Chesney PJ, Wand PJ, LaVenture M.  Toxic-shock syndrome: epidemiologic features, recurrence, risk factors, and prevention . N Engl J Med 1980;;303:1429-35.
9 +
Shands KN, Schmid GP, Dan BB, et al.  Toxicshock syndrome in menstruating women: association with tampon use and Staphylococcus aureus and clinical features in 52 cases . N Engl J Med 1980;;303;1436-42.
10 +
Schlech WF III, Shands KN, Reingold AL, et al.  Risk factors for development of toxic shock syndrome: association with a tampon brand . JAMA 1982;;248:835-9.
11 +
Osterholm MT, Davis JP, Gibson RW, et al.  Tristate toxic-shock syndrome study. I. Epidemiologic findings . J Infect Dis 1982;;145:431-40.
12 +
CDC.  Follow-up on toxic-shock syndrome— United States . MMWR 1980;;29:297-9.
13 +
CDC.  Follow-up on toxic-shock syndrome . MMWR 1980;;29:441-5.
14 +
Curran WJ.  Protecting confidentiality in epidemiologic investigations by the Centers for Disease Control . N Engl J Med 1986;;314:1027-8.
15 +
Farnsworth v. Proctor & Gamble Company. 758 F.2d 1545(11 Cir. 1985).

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Todd J, Fishaut M, Kapral F, Welch T.  Toxicshock syndrome associated with phage-group-I staphylococci . Lancet 1978;;2:1116-8.
2 +
Everett ED.  Mucocutaneous lymph node syndrome (Kawasaki disease) in adults . JAMA 1979;; 242:542-3.
3 +
Schlossberg D, Kandra J, Kreiser J.  Possible Kawasaki disease in a 20-year-old woman . Arch Dermatol 1979;;115:1435-6.
4 +
Todd J, Fishaut M.  Toxic-shock syndrome associated with phage-group-I staphylococci . Lancet 1978;;2:1116-8.
5 +
Petitti DB, Reingold AL, Chin J.  The incidence of toxic shock syndrome in Northern California, 1972 through 1983 . JAMA 1986;;255:368-72.
6 +
Petitti DB, Reingold AL.  Recent trends in the incidence of toxic shock syndrome in Northern California . Am J Public Health 1991;;81:1209-11.
7 +
Todd JK, Wiesenthal AM, Ressman M, Caston SA, Hopkins RS.  Toxic shock syndrome. II. Estimated occurrence in Colorado as influenced by case ascertainment methods . Am J Epidemiol 1985;;122:857-67.
8 +
Davis JP, Chesney PJ, Wand PJ, LaVenture M.  Toxic-shock syndrome: epidemiologic features, recurrence, risk factors, and prevention . N Engl J Med 1980;;303:1429-35.
9 +
Shands KN, Schmid GP, Dan BB, et al.  Toxicshock syndrome in menstruating women: association with tampon use and Staphylococcus aureus and clinical features in 52 cases . N Engl J Med 1980;;303;1436-42.
10 +
Schlech WF III, Shands KN, Reingold AL, et al.  Risk factors for development of toxic shock syndrome: association with a tampon brand . JAMA 1982;;248:835-9.
11 +
Osterholm MT, Davis JP, Gibson RW, et al.  Tristate toxic-shock syndrome study. I. Epidemiologic findings . J Infect Dis 1982;;145:431-40.
12 +
CDC.  Follow-up on toxic-shock syndrome— United States . MMWR 1980;;29:297-9.
13 +
CDC.  Follow-up on toxic-shock syndrome . MMWR 1980;;29:441-5.
14 +
Curran WJ.  Protecting confidentiality in epidemiologic investigations by the Centers for Disease Control . N Engl J Med 1986;;314:1027-8.
15 +
Farnsworth v. Proctor & Gamble Company. 758 F.2d 1545(11 Cir. 1985).

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