When viewing this topic in a different language, you may notice some differences in the way the content is structured, but it still reflects the latest evidence-based guidance.

Síndrome do choque tóxico

  • 概述
  • 理论
  • 诊断
  • 治疗
  • 随访
  • 资源
最后审阅： 20 Aug 2025
最后更新： 22 Aug 2024

小结

定义

病史和体格检查

关键诊断因素

  • dor intensa difusa ou localizada em um membro
  • febre
  • edema ou eritema localizados
  • hipotensão
  • rash eritematoso difuso escarlatiniforme
完整详情

其他诊断因素

  • alterações agudas do estado mental
  • sintomas tipo influenza
  • sensibilidade e fraqueza muscular
  • sintomas gastrointestinais
  • sinais e sintomas de miocardite
  • endoftalmite
  • hipotermia
完整详情

危险因素

  • diabetes mellitus
  • transtornos decorrentes do uso de bebidas alcoólicas
  • traumas menores e lesões com hematomas, formação de hematomas ou distensão muscular
  • procedimentos cirúrgicos (por exemplo, parto vaginal, reconstrução da mama, parto cesáreo, histerectomia, lipossucção, bunionectomia)
  • uso prolongado (>6 horas) do mesmo absorvente higiênico interno
  • uso de absorventes higiênicos internos de alta absorção
  • uso de anti-inflamatórios não esteroidais (AINEs)
  • uso de esponjas vaginais, diafragmas e dispositivos intrauterinos (DIUs)
  • faringite estreptocócica não tratada
完整详情

诊断性检查

首要检查

  • microscopia e cultura (sangue, ferida, líquido, tecido)
  • Hemograma completo
  • perfil de coagulação
  • ureia e creatinina séricas
  • urinálise
  • TFHs
  • creatina quinase (CK)
  • cálcio sérico
  • sódio sérico
  • fósforo sérico
  • albumina sérica
  • ácido lático sérico
完整详情

需考虑的检查

  • teste de anticorpos anti-Staphylococcus aureus
  • radiografia torácica
完整详情

新兴检查

  • sorotipagem

治疗流程

初步治疗

suspeita de síndrome do choque tóxico

急症处理

síndrome do choque tóxico estreptocócico confirmada

síndrome do choque tóxico estafilocócico confirmada: sensível à meticilina

síndrome do choque tóxico estafilocócico confirmada: resistente à meticilina

síndrome do choque tóxico clínico sem culturas confirmadas

撰稿人

作者

Brit Jeffrey Long, MD

Attending Physician

Associate Professor of Emergency Medicine

Department of Emergency Medicine

Brooke Army Medical Center

Fort Sam Houston

TX

利益声明

BJL declares that he has no competing interests.

鸣谢

Dr Brit J. Long would like to gratefully acknowledge Dr Marie R. Baldisseri and Dr Walid Khayr, previous contributors to this topic.

利益声明

MRB and WK declare they have no competing interests.

同行评议者

Mary Jane Reed, MD, FACS, FASMBS

Associate Professor

Department of Critical Care Medicine and Department of General Surgery

Geisinger Medical Center

Danville

PA

利益声明

MJR declares that she has no competing interests.

Janice Zimmerman, MD

Head

Critical Care Division

The Methodist Hospital

Houston

TX

利益声明

JZ declares that she has no competing interests.

Djillali Annane, MD, PhD

Professor in Medicine at University of Versailles SQY

Director of the General ICU at Raymond Poincaré Hospital (AP-HP)

Director of the Center for Clinical Research and Technology Innovation (INSERM)

Garches

France

利益声明

DA is an author of a number of references cited in this topic.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

参考文献

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

关键文献

Centers for Disease Control and Prevention. Streptococcal toxic shock syndrome (STSS): 2010 case definition. 2010 [internet publication].​全文

Evans L, Rhodes A, Alhazzani W, et al. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021. Crit Care Med. 2021 Nov 1;49(11):e1063-143.全文  摘要

Stevens DL, Bisno AL, Chambers HF, et al. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America. Clin Infect Dis. 2014 Jul 15;59(2):e10-52.全文  摘要

Sartelli M, Guirao X, Hardcastle TC, et al. 2018 WSES/SIS-E consensus conference: recommendations for the management of skin and soft-tissue infections. World J Emerg Surg. 2018;13:58.全文  摘要

参考文献

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • Síndrome do choque tóxico images

  • 鉴别诊断

    • Sepse Gram-negativa
    • Febre maculosa das Montanhas Rochosas (FMMR)
    • Meningococcemia aguda
    更多 鉴别诊断

  • 指南

    • Surviving sepsis campaign: international guidelines for management of sepsis and septic shock: 2021
    • Invasive group A streptococcal disease: management and chemoprophylaxis
    更多 指南
  • padlock-locked登录或订阅即可浏览 BMJ Best Practice 临床实践完整内容

内容使用需遵循免责声明