Case Definition of Streptococcal Toxic-Shock Syndrome (Streptococcal TSS) and Necrotizing Fasciitis*

I. Streptococcal TSS

A. Isolation of group A Streptococcus

1. From a sterile site

2. From a nonsterile body site

B. Clinical signs of severity

1. Hypotension

2. Clinical and laboratory abnormalities (requires two or more of the following):

a) Renal impairment

b) Coagulopathy

c) Liver abnormalities

d) Acute respiratory distress syndrome

e) Extensive tissue necrosis, i.e., necrotizing fasciitis

f) Erythematous rash

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Diagnostic Criteria for Necrotizing Enterocolitis (NEC)

Necrotizing enterocolitis is among the most common and devastating diseases in neonates. The excessive inflammatory process initiated in the highly immunoreactive intestine in necrotizing enterocolitis extends the effects of the disease systemically, affecting distant organs such as the brain and placing affected infants at substantially increased risk for neurodevelopmental delays.

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