Pediatric emergency medicine trisk 591

e-TABLE 94.1 CASE DEFINITIONS FOR STAPHYLOCOCCAL AND STREPTOCOCCAL TOXIC SHOCK SYNDROME a Clinical criteria Laboratory criteria Staphylococcal Fever ≥102.2°F (≥38.9°C) b Streptococcal c Blood or CSF cultures positive for S aureus and Rash: diffuse macular erythroderma Negative serologies for other pathogens that Desquamation: 1–2 wks after rash can mimic TSS: onset RMSF, leptospirosis, measles Hypotension Multisystem involvement: • GI: vomiting or diarrhea at onset of illness • Muscular: myalgias or CK at least 2ì ULN ã Mucous membrane: hyperemia of conjunctival, oropharynx, or vagina • Renal: BUN or creatinine at least 2ì ULN or pyuria ã Hepatic: total bilirubin, ALT, or AST at least 2ì ULN ã Hematologic: platelets