Toxic Shock Syndrome and Necrotizing Fasciitis (Flesh-Eating Disease)

by Carlo Raj, MD

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    00:01 Our topic here is toxic shock syndrome.

    00:05 Fever.

    00:06 Hypotension, erythema following a streptococcal infection.

    00:11 So now, way back when in pathophysiology in cardiology, we did our shock, shock, shock.

    00:18 So now, we have a septic-type shock.

    00:20 And when we do so, remember your patients with any type of shock, hypovolemic shock, septic shock ,or whatever, or distributive shock, then may result in hypotension due to a superantigen produced by the bacteria.

    00:35 Superantigen produced by the bacteria, most commonly seen in women using tampons.

    00:41 Do not forget this.

    00:43 You see this, I don’t want to say quite commonly, but often enough in which the tampon has been inserted and has been lying around for too long.

    00:54 And unfortunately is introducing a staph infection.

    00:58 No joke.

    01:02 Management: Clindyamycin for the toxin production, vancomycin or nafcillin to kill the staph, make sure that you know this in greater detail.

    01:13 Our topic here is necrotizing fasciitis.

    01:17 A necrotizing fasciitis, what is it? A necrotizing infection of the deep subcutaneous tissue.

    01:23 Look at this, it is not pretty.

    01:27 Type I: Mixed aerobic and anaerobic bacteria, most common in diabetics.

    01:32 And type II: Think of MRSA or group A streptococci.

    01:36 Most common in otherwise healthy patients.

    01:40 Two types of fasciitis.

    01:42 Think of the fascia, the deep portion of your subcutaneous that then undergoes infection.

    01:49 Type I, mixed.

    01:50 Type II, group A streptococci.

    01:54 Management: Surgical debridement of involved fascia.

    01:59 Antibiotics for type I suspected would then be ampicillin-sulbactam.

    02:05 Type II, clindamycin, penicillin G or vancomycin if it’s MRSA.

    About the Lecture

    The lecture Toxic Shock Syndrome and Necrotizing Fasciitis (Flesh-Eating Disease) by Carlo Raj, MD is from the course Infectious Skin Diseases. It contains the following chapters:

    • Toxic Shock Syndrome
    • Necrotizing Fasciitis

    Author of lecture Toxic Shock Syndrome and Necrotizing Fasciitis (Flesh-Eating Disease)

     Carlo Raj, MD

    Carlo Raj, MD

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