- Severe septic shock caused by certain bacterial infections, primarily Staphylococcus aureus and Streptococcus pyogenes
- Caused by superantigens, which non-specifically activate T-cells
- Similar syndrome can be caused by toxin production of Clostridium sordelli
| Criteria | Staphylococcal | Streptococcal |
|---|---|---|
| Confirmed | hypotension + fever + rash + desquamating + 3 or more other | hypotension + 2 or more other |
| Hypotension | SBP ≤90 mmHg | SBP ≤90 mmHg |
| Fever | temp ≥38.9ºC | |
| Skin | diffuse macular erythroderma followed by desquamation | generalized erythematous macular rash that may desquamate |
| GI | n/v/d at onset | |
| Resp | ARDS | |
| MSK | myalgia ± CK ≥2x ULN | soft-tissue necrosis (e.g. nec.fasc) |
| Mucosa | hyperemia of any mucosa | |
| Nephro | Creatinine ≥2x ULN, or pyuria without UTI |
Creatinine ≥177 or ≥2x ULN or ≥2x baseline |
| Hepatic | bili/ALT/AST ≥2x ULN | ALT/AST/bili ≥2x ULN or ≥2x baseline |
| Heme | thrombocytopenia <100 | thrombocytopenia ≤100, or DIC (INR/fibrinogen/D-dimer) |
| CNS | altered LOC without focal signs |
