Clostridial toxic shock syndrome

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Background

Clinical Manifestations

  • Hemoconcentration with high hematocrit and hemoglobin
  • Capillary leak causing edema and ascites
  • Leukemoid reaction
  • Often afebrile

Management

  • Fluid resuscitation
  • Penicillin G 18-20 million units daily divided q4-6h
  • Plus clindamycin 900 mg IV q8h for toxin production