title: [Streptococcal toxic shock syndrome: ten years' experience at a tertiary hospital].
abstract: BACKGROUND
  In the last two decades there has been a reported increase in the incidence of streptococcal toxic shock syndrome (STSS). The objective of this study was to determine the clinical and epidemiological characteristics of this infection.
  
  
  METHODS
  Retrospective study of all cases of STSS diagnosed at a single tertiary hospital over the last ten years.
  
  
  RESULTS
  We report 13 cases of STSS (8 men, mean age 62 years). The mean annual incidence was 0.19 episodes/100,000 population from 1994 to 1998 and 0.53 episodes/100,000 population from 1999 to 2003 (p = 0.059). All patients had at least one underlying disease and there were no intravenous drug users. The most common portals of entry were the skin and soft tissues (85%) and all but one patient had a positive blood culture. Two cases were nosocomial and five patients required surgery (amputation and/or debridement). There was a high mortality rate (85%) and a rapid course from onset to death; nine patients died within four days after establishing the diagnosis.
  
  
  CONCLUSIONS
  The incidence of SSTS has increased over the last five years at our hospital. Elderly patients with underlying medical conditions were more susceptible to acquiring this infection. Early mortality was very high.
authors.affiliation: Servicio de Medicina Interna, Hospital Universitario La Fe, Valencia, Spain. mvallalta@hotmail.com
authors.forename: Manuel
authors.initials: M
authors.lastname: Vallalta-Morales
authors.forename: Miguel
authors.initials: M
authors.lastname: Salavert-Lletí
authors.forename: Arturo
authors.initials: A
authors.lastname: Artero-Mora
authors.forename: Laura
authors.initials: L
authors.lastname: Mahiques-Santos
authors.forename: Elena
authors.initials: E
authors.lastname: Solaz-Moreno
authors.forename: Carmen
authors.initials: C
authors.lastname: Pérez-Bellés
mesh_terms: D000328:Adult; D000368:Aged; D000671:Amputation, Surgical; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000453:epidemiology; D003131:Combined Modality Therapy; D015897:Comorbidity; D003428:Cross Infection / Q000453:epidemiology; D003646:Debridement; D004198:Disease Susceptibility; D005260:Female; D017052:Hospital Mortality; D006785:Hospitals, University / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012772:Shock, Septic / Q000188:drug therapy / Q000453:epidemiology* / Q000401:mortality / Q000601:surgery; D013030:Spain / Q000453:epidemiology; D013290:Streptococcal Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000401:mortality / Q000601:surgery; D013297:Streptococcus pyogenes
chemical_list: D000900:Anti-Bacterial Agents