Toxic Shock Syndrome in Children Aged 10 Years or Less

Eight children aged 10 years or less had toxic shock syndrome, and medical records were reviewed for seven of them. There were four boys and three girls, ranging in age from 5 5/12 to 10 8/12 years; all seven met the Centers for Disease Control case definition of toxic shock syndrome. One boy died. The illness was generally characterized by fever, followed by erythroderma, gastrointestinal complaints, and mucous membrane hyperemia. Based on the need for supplemental oxygen or mechanical ventilation, the girls tended to have milder courses than the boys. In four of four cultures performed prior to the institution of antibiotic therapy. Staphylococcus aureus grew from one or more sites. One boy also met the case definition of Kawasaki syndrome and has had multiple coronary artery aneurysms demonstrated in early and late follow-up. Toxic shock syndrome in these children was similar to published descriptions of toxic shock syndrome in series of adult patients, except that, as a group, the children had a greater incidence of respiratory embarrassment.