Toxic shock syndrome other diagnostic studies

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1],Associate Editor(s)-in-Chief: Mahshid Mir, M.D. [2]

Review:

Although the best diagnostic tool for TSS diagnosis is with clinical findings and laboratory exams, there are still some imaging and specific diagnostic ways specially for early diagnosis of TSS complications.

Imaging

Different imaging methods during toxic shock syndrome (TSS) evaluation are more useful to assess the disease complications, and for early diagnosis and treatment of complications.

CXR

Diffuse bilateral interstitial and alveolar infiltrates may be seen in CXR (as a result of pulmonary and cardiac complications)

Brain CT-scan

Midline shift, or effacement of the basilar cisterns may be seen due to cerebral edema. Some experts insist in the usefulness of magnetic resonance imaging because of its sensitivity, although the imaging technique lacks specificity in the diagnosis of TSS related complications.[1][2]


Frozen-section biopsy

The use of specimens of suspected areas of tissue may enable early recognition of NF; however, the expertise to process and interpret biopsy specimens is not readily available in most clinical settings where and when patients present[3].

Staphylococcus aureus antibody testing

Presence of Staphylococcus aureus in the absence of an acute-phase antibody can be highly suggestive of Staphylococcal TSS.

References

  1. Kim KT, Kim YJ, Won Lee J, Kim YJ, Park SW, Lim MK, Suh CH (2011). "Can necrotizing infectious fasciitis be differentiated from nonnecrotizing infectious fasciitis with MR imaging?". Radiology. 259 (3): 816–24. doi:10.1148/radiol.11101164. PMID 21406630.
  2. Malghem J, Lecouvet FE, Omoumi P, Maldague BE, Vande Berg BC (2013). "Necrotizing fasciitis: contribution and limitations of diagnostic imaging". Joint Bone Spine. 80 (2): 146–54. doi:10.1016/j.jbspin.2012.08.009. PMID 23043899.
  3. Stamenkovic I, Lew PD (1984). "Early recognition of potentially fatal necrotizing fasciitis. The use of frozen-section biopsy". N. Engl. J. Med. 310 (26): 1689–93. doi:10.1056/NEJM198406283102601. PMID 6727947.


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