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Which of the options are incorrect regarding the following patient?



  A 23-year-old healthy female presents 4 days after an elective rhinoplasty.  She complains of fever and flu-like symptoms and she is now vomiting and somewhat confused.  Her vital signs are temperature 102.9, HR 126, BP 82/53.  On exam, you note diffuse erythema.  In regards to her diagnosis,

A. This illness has been associated with an exotoxin-producing S. aureus and severe group A beta-hemolytic streptococcal infections
B. The diagnosis of this illness requires fever, hypotension, and rash
C. You can see pharyngitis, a “strawberry tongue,” conjunctivitis or vaginitis with this illness
D. The rash associated with this illness is initially a diffuse, blanching erytHRoderma followed by full-thickness desquamation
E. Antibiotics are not indicated in the treatment of this illness
Asked by Laidley on Sep 08, 2016

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1 Answer

John Smith

John Smith

Answered on Sep 08, 2016

Antibiotics are not indicated in the treatment of this illness-toxic shock syndrome (tss) is an acute febrile illness characterized by a diffuse desquamating erythroderma. most cases occur in the postoperative setting. tss has been linked to exotoxin-producing s. aureus and with severe group a beta-hemolytic streptococcal infections. non-specific symptoms are followed by septic shock and multi-system organ failure. diagnosis of tss requires (1) fever of at least 38.9 c, (2) hypotension (sbp < 90 mmhg), (3) skin rash, and (4) involvement of at least three organ systems. the rash is typically a diffuse, blanching, macular erythroderma, often with mucous membrane inflammation. pharyngitis, a strawberry tongue, conjunctivitis, or vaginitis may also be seen. the rash fades within approximately 3 days and is followed by full-thickness desquamation, most commonly of the hands and feet. treatment consists of ivf, ventilatory support, vasopressors, penicillinase-resistant antibiotics, and drainage of any infected sites. (chapter 118)
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