Clostridial toxic shock syndrome
From IDWiki
Background
- Toxic shock syndrome caused by Clostridium sordellii (also Clostridium perfringens)
- Most commonly after spontaneous or therapeutic abortion
Clinical Manifestations
- Tachycardia and hypotension
- Often afebrile
- Hemoconcentration with high hematocrit and hemoglobin
- Capillary leak causing anasarca and effusions (pleural, pericardial, ascites)
- Leukemoid reaction, with a median peak of 90-100, and the degree of which predicts mortality
Management
- Fluid resuscitation
- Penicillin G 18-20 million units daily divided q4-6h
- Plus clindamycin 900 mg IV q8h for toxin production
