[Toxic shock syndrome consecutive to the presence of vaginal tampon for menstruation regressive after early haemodynamic optimization and activated protein C infusion]

Author(s): Ellies E, Vallee F, Mari A, Silva S, Bauriaud R, Fourcade O, Genestal M

Affiliation(s): Pole anesthesie et reanimation, unite de reanimation polyvalente, hopital Purpan, centre hospitalier universitaire, place du Docteur-Baylac, TSA 40031, 31059 Toulouse cedex 9, France.

Publication date & source: 2009-01, Ann Fr Anesth Reanim., 28(1):91-5. Epub 2008 Dec 23.

Publication type: Case Reports; English Abstract

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.