Clinical Profile, Intensive Care Needs, and Short-Term Outcome of Toxic Shock Syndrome Among Children: A 10-Year Single-Centre Experience from North India

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dc.contributor.authorAngurana, Suresh Kumaren_US
dc.contributor.authorAwasthi, Pusprajen_US
dc.contributor.authorK.C., Sudeepen_US
dc.contributor.authorNallasamy, Karthien_US
dc.contributor.authorBansal, Arunen_US
dc.contributor.authorJayashree, Muralidharanen_US
dc.date.accessioned2023-08-19T04:53:37Z
dc.date.available2023-08-19T04:53:37Z
dc.date.issued2023-04
dc.description.abstractObjective To describe the clinical and laboratory profle, management, intensive care needs, and outcome of children with toxic shock syndrome (TSS) admitted to the pediatric intensive care unit (PICU) of a tertiary care center in North India. Methods This retrospective study was conducted in the PICU of a tertiary care hospital in North India over a period of 10 y (January 2011–December 2020) including children<12 y with TSS (n=63). Results The median (interquartile range, IQR) age was 5 (2–9) y, 58.7% were boys, and Pediatric Risk of Mortality III (PRISM-III) score was 15 (12–17). The primary focus of infection was identifed in 60.3% children, 44.5% had skin and soft tissue infections, and 17.5% (n=11) had growth of Staphylococcus aureus. Common manifestations were shock (100%), rash (95.2%), thrombocytopenia (79.4%), transaminitis (66.7%), coagulopathy (58.7%), and acute kidney injury (AKI) (52.4%); and involvement of gastrointestinal (61.9%), mucus membrane (55.5%), respiratory (47.6%), musculoskeletal (41.3%), and central nervous system (CNS) (31.7%). The treatment included fuid resuscitation (100%), vasoactive drugs (92.1%), clindamycin (96.8%), intravenous immunoglobulin (IVIG) (92.1%), blood products (74.6%), mechanical ventilation (58.7%), and renal replacement therapy (31.7%). The mortality was 27% (n=17). The duration of PICU and hopsital stay was 5 (4–10) and 7 (4–11) d, respectively. Higher proportion of nonsurvivors had CNS involvement, transaminitis, thrombocytopenia, coagulopathy, and AKI; required mechanical ventilation and blood products; and had higher vasoactive–inotropic score. Conclusion TSS is not uncommon in children in Indian setup. The management includes early recognition, intensive care, antibiotics, source control, and adjunctive therapy (IVIG and clindamycin). Multiorgan dysfunction and need for organ supportive therapies predicted mortality.en_US
dc.identifier.affiliationsDivision of Pediatric Emergency and Critical Care, Department of Pediatrics, Advanced Pediatrics Center, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh 160012, Indiaen_US
dc.identifier.citationAngurana Suresh Kumar, Awasthi Puspraj, K.C. Sudeep, Nallasamy Karthi, Bansal Arun, Jayashree Muralidharan. Clinical Profile, Intensive Care Needs, and Short-Term Outcome of Toxic Shock Syndrome Among Children: A 10-Year Single-Centre Experience from North India. Indian Journal of Pediatrics. 2023 Apr; 90(4): 334–340en_US
dc.identifier.issn0973-7693
dc.identifier.issn0019-5456
dc.identifier.placeIndiaen_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/223749
dc.languageenen_US
dc.publisherDr. K C Chaudhuri Foundationen_US
dc.relation.issuenumber4en_US
dc.relation.volume90en_US
dc.source.urihttps://doi.org/10.1007/s12098-022-04271-4en_US
dc.subjectStaphylococcus aureusen_US
dc.subjectIntravenous immunoglobulinen_US
dc.subjectShocken_US
dc.subjectClindamycinen_US
dc.subjectMechanical ventilationen_US
dc.subjectVasoactive drugsen_US
dc.titleClinical Profile, Intensive Care Needs, and Short-Term Outcome of Toxic Shock Syndrome Among Children: A 10-Year Single-Centre Experience from North Indiaen_US
dc.typeJournal Articleen_US
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