Diagnostic value of Vbeta2-positive T-cell expansion in toxic shock syndrome.
BACKGROUND
diagnostic dilemma in toxic shock syndrome (TSS) is that the results of microbiologic investigations are often not available immediately because of the need for incubation, or no obvious entry point can be found.


METHODS
We describe three patients with a clinical diagnosis of TSS in whom microbiologic tests were negative.


RESULTS
All patients had complicated courses with vasopressor-dependent shock, renal and respiratory failure, and disseminated intravascular coagulation for at least 1 week. In all three patients, diagnosis was considerably faster with the assessment of the expansion of T-cell-receptor Vbeta2-positive T cells (> 15%) than by Centers for Disease Control and Prevention (CDC) diagnosis, because of the complicated clinical picture or the delay caused by waiting for the results of microbiologic investigations.


CONCLUSIONS
Our results indicate that diagnostic procedures incorporating Vbeta2-positive T cells could be a useful tool for the diagnosis of TSS.
Wenisch
Christoph
C
4. Med. Abt. Infektions und Tropenmedizin, SMZ-Süd KFJ Spital, Wien, Austria. chiristoph.wenisch@wienkav.at
Strunk
D
D
Krause
R
R
Smolle
K H
KH
D000208:Acute Disease; D000328:Adult; D001427:Bacterial Toxins / Q000276:immunology; D042241:Early Diagnosis; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D008297:Male; D016693:Receptors, Antigen, T-Cell, alpha-beta / Q000097:blood*; D012772:Shock, Septic / Q000175:diagnosis* / Q000276:immunology / Q000382:microbiology; D013203:Staphylococcal Infections / Q000175:diagnosis* / Q000276:immunology / Q000382:microbiology; D013211:Staphylococcus aureus / Q000276:immunology; D018089:Superantigens / Q000276:immunology; D013601:T-Lymphocytes / Q000276:immunology / Q000378:metabolism*
D001427:Bacterial Toxins; D016693:Receptors, Antigen, T-Cell, alpha-beta; D018089:Superantigens