Early diagnosis and treatment of toxic shock syndrome in paediatric burns

Young children with burns are at risk of developing toxic shock syndrome (TSS), which is an exotoxin mediated disease usually caused by Staphylococcus aureus (S. aureus). The diagnosis of TSS is difficult because in the early stages the signs and symptoms resemble other common childhood illnesses such as scarlet fever. If the condition is not treated promptly it has a high mortality. The South West Regional Paediatric Burns Unit at Frenchay Hospital admits 150–200 burns per year. We have designed a protocol to facilitate the early diagnosis and treatment of TSS. We report our experience over a 3-year period in which almost one quarter of cases of TSS were admitted from home or another hospital. During this period all children with TSS survived and none needed ventilatory support. Typical cases presented within 2 days of thermal injury, in a child under 2 years old with a burn of less than 10% of body surface area (BSA).