IBCC Episode 108 - Toxic Shock Syndrome

In this episode of The Internet Book of Critical Care Podcast, Josh and Adam discuss strep and staph toxic shock syndromes, including their pathophysiology, diagnosis, and treatment. They explain the mechanism of toxic shock syndrome involving super antigens and the resulting cytokine storm, differentiating between staph and strep toxic shock based on the presence of neutralizing antibodies in different age groups. They cover the epidemiology, clinical presentation, and red flags for identifying these infections, emphasizing the importance of recognizing subtle signs and potential multi-organ failure. The hosts also discuss lab tests, differential diagnoses, and the overall approach to diagnosis, including the limitations of CDC diagnostic criteria. The conversation further covers treatment strategies such as basic sepsis resuscitation, antibiotic choices (emphasizing toxin-suppressing antibiotics), source control, and the controversial use of IVIG, including a discussion of relevant trials and practical considerations for its administration. Finally, they touch on the importance of contact and droplet precautions to prevent nosocomial transmission.