[Toxic shock syndrome consecutive to the presence of vaginal tampon for menstruation regressive after early haemodynamic optimization and activated protein C infusion].
A 19-year-old woman was admitted in the intensive care unit for a septic shock recognized as a menstrual toxic shock syndrome with a Staphylococcus aureus. An early goal oriented therapy was started in order to correct in particular the venous central O(2) saturation (ScvO(2)) associated to an early empiric anti-infectious treatment. A multi-organ failure appeared in a second time, so that we began a protein C activated infusion. The outcome was also auspicious. Bacteriologic samples and specific samples for the research of Staphylococci toxins confirmed the diagnosis of toxic shock syndrome with Staphylococcus aureus. A genotypic study allowed us to identify many anomalies which could be involved in the incompletely understood physiopathology of this disease.
Ellies
E
E
Pole anesthésie et réanimation, unité de réanimation polyvalente, hôpital Purpan, centre hospitalier universitaire, place du Docteur-Baylac, TSA 40031, 31059 Toulouse cedex 9, France.
Vallée
F
F
Mari
A
A
Silva
S
S
Bauriaud
R
R
Fourcade
O
O
Genestal
M
M
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000925:Anticoagulants / Q000008:administration & dosage / Q000627:therapeutic use*; D002981:Clindamycin / Q000627:therapeutic use; D005260:Female; D005838:Genotype; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D007262:Infusions, Intravenous; D015850:Interleukin-6 / Q000235:genetics; D052576:Menstrual Hygiene Products / Q000009:adverse effects*; D009102:Multiple Organ Failure / Q000209:etiology / Q000628:therapy; D010100:Oxygen / Q000097:blood; D011486:Protein C / Q000008:administration & dosage / Q000627:therapeutic use*; D012772:Shock, Septic / Q000188:drug therapy* / Q000209:etiology*; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000209:etiology; D055815:Young Adult
D000900:Anti-Bacterial Agents; D000925:Anticoagulants; D015850:Interleukin-6; D011486:Protein C; D002981:Clindamycin; D010100:Oxygen