Abstract
[Objective]We aimed to examine the clinical course of patients with toxic shock syndrome (TSS) from onset to diagnosis and to evaluate the reasons for misdiagnosis or diagnostic delay in a single center in Japan.
[Methods]We retrospectively evaluated the characteristics of TSS cases at two hospitals in Japan. We reviewed the medical records of patients diagnosed with TSS admitted to our hospital between April 2011 and January 2019.
[Results] Eleven patients were evaluated. The triggers for TSS were tampon use during menstruation, burns, erysipelas, vaginal delivery, surgery for appendicitis, and respiratory tract infections. The most common initial symptoms were fever, vomiting, diarrhea, and erythema. Three patients fulfilled all five diagnostic criteria defined by the Centers for Disease Control and Prevention. Two patients only fulfilled four criteria and three six criteria.
[Conclusions]TSS has no specific symptoms, and its diagnostic criteria are unsuitable for achieving an early diagnosis. Therefore, diagnostic errors are possible in early-stage TSS cases. Physicians should consider the possibility of TSS if patients present with a poor general appearance with fever, digestive symptoms, and/or erythema, despite not fulfilling the diagnostic criteria for TSS.
