Síndromes de choque tóxico

• Autor(a) principal: Diogo Carvalho Pereira de Sá
• Data de Publicação: 2018
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: https://hdl.handle.net/10216/114327
• topic: Medicina clínica; Clinical medicine

Background: The staphylococcal TSS was first named in 1978 and it was associated two years later to the use of vaginal tampons. In 1987, the streptococcal TSS was described in patients who had invasive Streptococcus pyogenes infections. The ultimate goal of this review was, through the gathering of information, to aid clinicians in their practice. Methods: A Pubmed search was conducted using the hereunder keywords. Other articles were added through the review of the selected articles' references. Relevant websites were also included. Results: Since the 80s the incidence of staphylococcal TSS has declined with the mortality rate being higher in menstrual TSS. Although being less frequent, the streptococcal TSS has a higher mortality rate. This syndromes are caused by the production of superantigens that over activate in a non-conventional way the T-cells, with a massive release of inflammatory cytokines. The progression to multiple organ dysfunction can happen fast with other symptoms such as hypotension, rash, fever and cutaneous desquamation. The treatment comprises the identification of possible sources of infection and their removal, intensive care support, broad-spectrum antibiotics including clindamycin and the patient can also benefit from the administration of intravenous immunoglobulin. Discussion: It is essential to continue the research in this area with focus on the treatment. Future studies can explore the therapeutic potential of monoclonal antibodies and Vβ proteins. Conclusion: Proper timing and adequacy of diagnosis and treatment of TSS are of paramount importance to reduce the high levels of morbidity and mortality of this syndrome. Keywords: Toxic shock syndrome; Septic shock; Superantigens; Staphylococcus aureus; Streptococcus pyogenes.