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Toxic shock syndrome and Kawasaki disease

This chapter assesses toxic shock syndrome (TSS) and Kawasaki disease. Staphylococcal and streptococcal TSS are acute-onset multiorgan illnesses. Staphylococcal TSS is caused by Staphylococcus aureus strains that produce pyrogenic toxin superantigens (SAgs), while streptococcal TSS is caused primarily by Streptococcus pyogenes (group A) strains but occasionally by groups B, C, and G strains. Several subsets of staphylococcal TSS exist, with two major categories being menstrual and nonmenstrual. Major risk factors for development of streptococcal TSS include chickenpox in children, penetrating and nonpenetrating wounds, use of nonsteroidal anti-inflammatory agents, and pregnancy. Meanwhile, Kawasaki syndrome (KS) is an acute multisystem vasculitis that occurs primarily in children younger than 4 years of age. KS shares many features with streptococcal scarlet fever and TSS except that hypotension is absent. This chapter reviews the treatment of both TSS and KS.