title: Fatal toxic shock syndrome from an intrauterine device.
abstract: Toxic shock syndrome is a rare toxin-mediated condition that can rapidly produce multiorgan failure and severe shock. Toxic shock syndrome has been previously recognized in various clinical situations relating to surgery, nasal packing, abscesses, burns, and most notably menstrual-related cases. This case report describes a previously healthy 33-year-old woman presenting to the emergency department with complaints of nausea, vomiting, and diarrhea; vital signs at triage were normal. Within hours, she developed shock and cardiopulmonary arrest. The patient met all 6 of the Centers for Disease Control and Prevention diagnostic criteria for toxic shock syndrome, and her intrauterine device grew out Staphylococcus aureus. To our knowledge, this is the first reported case in the medical literature of fatal toxic shock syndrome related to an intrauterine device.
authors: Division of Emergency Medicine, Denver Health Medical Center, Denver, CO 80204, USA. klugcd@hotmail.com
authors: Cameron D
authors: CD
authors: Klug
authors: C Ryan
authors: CR
authors: Keay
authors: Adit A
authors: AA
authors: Ginde
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D016638:Critical Illness; D020878:Device Removal; D018450:Disease Progression; D004636:Emergency Service, Hospital; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007434:Intrauterine Devices / Q000009:adverse effects* / Q000382:microbiology; D018570:Risk Assessment; D012772:Shock, Septic / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D013203:Staphylococcal Infections / Q000175:diagnosis* / Q000628:therapy; D013211:Staphylococcus aureus / Q000302:isolation & purification
chemical_list: D000900:Anti-Bacterial Agents