title: Menstrual toxic shock syndrome complicated by persistent bacteremia: case report and review.
abstract: An unusual case of menstrual toxic shock syndrome (TSS) is described in which the patient had persistent Staphylococcus aureus bacteremia despite therapy with iv cloxacillin. There was no demonstrable evidence of endocarditis or an abscess as a focus for persisting bacteremia. The strain of S. aureus isolated from the blood and vagina produced toxic shock syndrome toxin 1 (TSST-1) and enterotoxin A. Bacteremia occurs uncommonly in association with TSS; however, aggressive high-dose antistaphylococcal therapy should be instituted for treating this possible complication.
authors.affiliation: Department of Medicine, University of Western Ontario, London, Canada.
authors.forename: M A
authors.initials: MA
authors.lastname: Crowther
authors.forename: E D
authors.initials: ED
authors.lastname: Ralph
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents; D016470:Bacteremia / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology; D001427:Bacterial Toxins; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D004768:Enterotoxins / Q000096:biosynthesis; D005260:Female; D006801:Humans; D008598:Menstruation; D012772:Shock, Septic / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology; D013203:Staphylococcal Infections / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology; D013211:Staphylococcus aureus / Q000302:isolation & purification / Q000378:metabolism; D018089:Superantigens
chemical_list: D000900:Anti-Bacterial Agents; D001427:Bacterial Toxins; D004768:Enterotoxins; D018089:Superantigens; C030107:enterotoxin F, Staphylococcal; C026066:enterotoxin A, Staphylococcal