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May 7, 1982

Complex picture emerges for toxic shock syndrome

JAMA. 1982;247(17):2339-2340. doi:10.1001/jama.1982.03320420011006

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The changing clinical spectrum of toxic shock syndrome (TSS) should alert physicians to the possibility of the disease in a wide range of patients and settings, a panel of experts advised attendees at the recent American Society for Microbiology meeting in Atlanta.

The familiar profile of the toxic shock victim—a previously healthy, young, menstruating woman who uses tampons—still is accurate for the overwhelming number of cases. But increasingly, TSS is being recognized in men, children, and nonmenstruating women. Recent reports document the illness in post-surgical patients who have undergone procedures as diverse as tubal ligation and spinal fusion (JAMA 1982;247:1448-1450), in a neonate who apparently acquired the organism from his mother during a normal vaginal delivery, and in other conditions not associated with menstruation.

With the more complex picture of TSS emerging, several experts are calling for a more liberal case definition to help clinicians recognize the baffling disease.