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.