Pediatric emergency medicine trisk 2362 2362

Clinical criteria

Laboratory criteria

Staphylococcal Fever ≥102.2°F (≥38.9°C)
b

Streptococcal c

Blood or CSF cultures
positive for S. aureus
and
Rash: diffuse macular erythroderma Negative serologies for
other pathogens that
Desquamation: 1–2 wks after rash
can mimic TSS:
onset
RMSF, leptospirosis,
measles
Hypotension
Multisystem involvement:
• GI: vomiting or diarrhea at onset
of illness
• Muscular: myalgias or CK at least
2ì ULN
ã Mucous membrane: hyperemia of
conjunctival, oropharynx, or
vagina
ã Renal: BUN or creatinine at least
2ì ULN or pyuria
ã Hepatic: total bilirubin, ALT, or

AST at least 2ì ULN
ã Hematologic: platelets
<100,000/mm3
ã CNS: disorientation or alteration
in consciousness without focal
neurologic signs in the absence
of fever or hypotension
Hypotension
Isolation of GAS
Multisystem involvement (≥2)
• ARDS: diffuse pulmonary
infiltrates and hypoxemia in the
absence of CHF; generalized
edema; or pleural or peritoneal
effusion with hypoalbuminemia