Volume 9, Number 3—March 2003
Dispatch
Early and Definitive Diagnosis of Toxic Shock Syndrome by Detection of Marked Expansion of T-Cell-Receptor Vβ2-Positive T Cells
Yoshio Matsuda*
, Hidehito Kato*, Ritsuko Yamada*, Hiroya Okano*, Hiroaki Ohta*, Ken’ichi Imanishi*, Ken Kikuchi*, Kyouichi Totsuka*, and Takehiko Uchiyama*
, Hidehito Kato*, Ritsuko Yamada*, Hiroya Okano*, Hiroaki Ohta*, Ken’ichi Imanishi*, Ken Kikuchi*, Kyouichi Totsuka*, and Takehiko Uchiyama*
Table
Laboratory data on admission of case-patients
| Case-patient 1 Day 2 postpartum | Case-patient 2 Day 7 postpartum | |
|---|---|---|
| Laboratory findings (normal range) |
||
| Leukocytes (µL) (5,000–8,500) |
2,800 |
17,500 |
| Platelets (x104/µL) (13–40) |
12.2 |
19.8 |
| C-reactive protein (mg/dL) (0–0.4) |
46.4 |
22 |
| Total protein (g/dL) (6.5–8.2) |
3.8 |
5.9 |
| Albumin (g/dL (3.8–5.1) |
1.6 |
3 |
| Aspartate aminotransgerase (IU/L) (0–35) |
30 |
51 |
| Alanine aminotransgerase (IU/L) (0–35) |
10 |
53 |
| Lactic dehydrogenase (IU/L) (200–450) |
712 |
698 |
| Blood urea nitrogen (mg/dL) (5–12) |
29.5 |
12.4 |
| Creatine (mg/dL) (<0.8) |
2.58 |
0.72 |
| Uric acid (mg/dL) (1.2–4.5) |
9.2 |
2.5 |
| Natrium (mEq/L) (136–145) |
135 |
133 |
| Potassium (mEq/L) (3.5–5) |
4.6 |
3.3 |
| Chloride (mEq/L) (98–108) |
104 |
99 |
| Creatine kinase (IU/L) (10–70) |
244 |
|
| Prothrombin time (sec) (12–14) |
11.7 |
13.7 |
| Activated partial thrombospilastin time (sec) (24–36) |
36.7 |
43.2 |
| Fibrinogen (mg/dL) (400–650) |
674 |
668 |
| Antithrombin-III (%) (70–120) |
60 |
82 |
| Fibrinogen degeneration product (µg/mL) (<10) |
8.8 |
11.7 |
| D-dimer (µg/mL) (<0.2) |
5.22 |
3.93 |
| Thrombin/antithrombin complex (ng/mL) (<3.0) |
40 |
20.4 |
| Criteria for definite TSS (all criteria must be present) |
No |
Yes |
| >38.9°C |
Yes |
Yes |
| Rash with desquamation |
Yes |
|
| Hypotension <90mmHg |
Yes |
Yes |
| Clinical or laboratory abnormalities (>3 organs) |
||
| Gastrointestinal |
||
| Hepatic |
Yes |
Yes |
| Muscular |
||
| Mucous membrane |
Yes |
|
| Renal |
Yes |
Yes |
| Cardiovascular |
||
| CNS |
||
| Criteria for probable TSS |
No |
Yes |
| >3 criteria and desquamation or >5 criteria without desquamation |
||
| >38.9°C |
Yes |
Yes |
| Rash |
Yes |
|
| Hypotension |
Yes |
Yes |
| Myalgia |
||
| Vomiting and/or diarrhea |
||
| Mucous membrane inflammation |
Yes |
|
| Clinical or laboratory abnormalities |
||
| >2 organs |
||
| Gastrointestinal |
||
| Hepatic |
Yes |
Yes |
| Muscular |
||
| Mucous membrane |
Yes |
|
| Renal |
Yes |
Yes |
| Cardiovascular |
||
| Central nervous system |
Page created: December 07, 2010
Page updated: December 07, 2010
Page reviewed: December 07, 2010
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