The streptococcal form is associated with clinical infection often a necrotizing fascitis or myositis, and rarely with strep throat (The use of NSAIDS is highly associated with the development of streptococcal necrotizing fasciitis).
The staphylococcal is not associated with an obvious infection; half of staphylococcal toxic shock syndromes are due to tampons, half are due to surgical wound infections, which usually occur within 48 hours after surgery. Classic is with nasal packing, the tampon equivalent.
In both cases there is MOSF with a sunburn rash that involves the palms and soles.
MicrobiologyGroup A streptococci or S. aureus.
IVIG may not help in children for Group A strep (PubMed).
See each organism for details.
Debridement is key. No debridement and the patient will die. And with wound associated TSS the source DOES NOT LOOK INFECTED. It still HAS TO BE DEBRIDED. The caps are there for a purpose. Pay attention.
Not all IVIG preparations have the same anti-TSST activity (PubMed), so response could be less than you would hope.
ICD9 Codes (Soon to be supplanted by ICD10)
Toxic Shock Syndrome: 040.89.