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Toxic-Shock Syndrome (TSS)
2011 Case Definition
CSTE Position Statement Number: 10-ID-14
Clinical case definition
An illness with the following clinical manifestations:
- Fever: temperature greater than or
equal to 102.0°F (greater than or equal to 38.9°C)
- Rash: diffuse macular erythroderma
- Desquamation: 1-2 weeks after onset
of rash
- Hypotension: systolic blood pressure
less than or equal to 90 mm Hg for adults or less than fifth
percentile by age for children aged less than 16 years
- Multisystem involvement (three or more of the following organ systems):
- Gastrointestinal: vomiting or diarrhea at onset of illness
- Muscular: severe myalgia or creatine phosphokinase level at least twice the upper limit of normal
- Mucous membrane: vaginal, oropharyngeal, or conjunctival hyperemia
- Renal: blood urea nitrogen or creatinine at least twice the upper limit of normal for laboratory or urinary sediment with pyuria (greater than or equal to 5 leukocytes per high-power field) in the absence of urinary tract infection
- Hepatic: total bilirubin, alanine aminotransferase enzyme, or asparate aminotransferase enzyme levels at least twice the upper limit of normal for laboratory
- Hematologic: platelets less than 100,000/mm3
- Central nervous system: disorientation or alterations in consciousness without focal neurologic signs when fever and hypotension are absent
Laboratory criteria for diagnosis
Negative results on the following tests, if obtained:
- Blood or cerebrospinal fluid cultures blood culture may be positive for Staphylococcus aureus)
- negative serologies for Rocky Mountain spotted fever, leptospirosis, or measles
Case classification
Probable: a case which
meets the laboratory criteria and in which four of the five clinical
findings described above are present
Confirmed: a case which meets the laboratory
criteria and in which all five of the clinical findings described
above are present, including desquamation, unless the patient
dies before desquamation occurs
See also:
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