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

00:01 Here, we'll take a look at toxic shock syndrome of staphylococcal type.

00:05 Your patient will be suffering from fever, hypotension, erythema, following staphylococcal infection due to a superantigen produced by the bacteria.

00:15 Superantigen produced by the bacteria.

00:19 Superantigens are antigens that cause non-specific activation of T-cells, leading to massive cytokine release.

00:27 Toxic shock syndrome toxin or TSST-1, is a well known superantigen.

00:33 Most commonly seen in women using tampons. Do no forget this.

00:39 You see this -- I wanna say quite commonly, but often enough in which the tampon has been inserted and has been lying around for too long, and unfortunately, is introducing a staph infection. And no joke.

00:56 The characteristic sunburn rash of toxic shock syndrome appears in the early stages of the disease, and is commonly located on the palms and soles.

01:07 Desquamation occurs after 10-21 days.

01:10 Management, clindamycin for the toxin production, vancomycin or nafcillin to kill the staph. Make sure that you know this is great detail.

01:21 The topic here is necrotizing fasciitis. Now, necrotizing fasciitis, what is it? It's a necrotizing infection of the deep subcutaneous tissue. Look at this. It is not pretty.

01:37 Type I, mixed aerobic, anaerobic bacteria, most common in diabetics, and Type II, think of MRSA, a group of streptococci, most common in otherwise healthy patients.

01:50 Two types of fasciitis, think of the fascia, the deep portion of your subcutaneous, that then undergoes infection. Type I, mixed, Type II, group A streptococci.

02:05 Management, surgical debridement of involved fascia.

02:09 Antibiotics for Type I, suspected, would then be ampicillin-sulbactam, Type II, clindamycin, penicillin-G, or vancomycin if it's MRSA.