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

by Carlo Raj, MD

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    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.


    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

    Included Quiz Questions

    1. Fever
    2. Mucosal ulceration
    3. Chancre
    4. Hypertension
    5. Anemia
    1. Immunocompromised
    2. Immunocompetent
    3. Premenopause
    4. Infants
    5. Premature newborns

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

     Carlo Raj, MD

    Carlo Raj, MD


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    talented
    By Sam s. on 15. July 2018 for Toxic Shock Syndrome and Necrotizing Fasciitis (Flesh-Eating Disease)

    great explanation Few people have a talent in teaching. i think Dr Raj is one of them thank you so much

     
    Great overview. Wish that dermatology covered more topics, though.
    By Shakera S. on 17. October 2017 for Toxic Shock Syndrome and Necrotizing Fasciitis (Flesh-Eating Disease)

    Great overview. Wish that dermatology covered more topics, though. I enjoyed this overall. I like the transcript section. It allows me to review the material and read the speakers words verbatim. This is wonderful for all types of learning.