A Rare Presentation of Fulminant Toxic Shock Syndrome in a Healthy 10-Year-Old Male Patient

Abstract

Staphylococcal toxic shock syndrome (STSS) is characterized by acute, progressive illness with fever, rapid-onset hypotension, and multisystem organ failure. The clinical course of STSS is attributable to host response to exotoxins with superantigenic properties. Fulminant staphylococcal infection is often associated with a deep focus of infection. In this report, we present a 10-year-old boy with multisystem organ failure as a result of STSS, a rare fatal complication following soft tissue injury. The rapid and fulminant progression of the disease in our patient precluded early timely diagnosis of STSS that may have allowed for the initiation of life-saving supportive intervention. Furthermore, the rapidly developing STSS occurred without an identifiable infectious source. The diagnosis of STSS was made upon the sum total of the clinical presentation, laboratory and autopsy findings, and antemortem and postmortem microbiology studies. It is crucial for health care providers to be aware of the possibility of STSS, even in the absence of overt focal infections and risk factors. A high index of suspicion for STSS should be present in critically ill patients presenting with a precipitous course of sepsis, septic shock, or systemic inflammatory response syndrome (SIRS).