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
An illness with the following clinical manifestations:
Fever: temperature > 38.9º C (102º F)
Rash: diffuse macular erythroderma
Desquamation: 1-2 weeks after onset of illness, particularly palms and soles
Hypotension: systolic blood pressure < 90 mm Hg for adults or less than fifth percentile by age for children <16 years of age; orthostatic drop in diastolic blood pressure greater than or equal to 15 mm Hg from lying to sitting, orthostatic syncope, or orthostatic dizziness
A 1992 American College of Chest Physicians/Society of Critical Care Medicine consensus panel defined the following terms which are relevant to the discussion of septic shock:
Infection: Infection is a microbial phenomenon characterized by an inflammatory response to the presence of microorganisms or the invasion of normally sterile host tissue by those organisms.
Bacteremia: Bacteremia refers to the presence of viable bacteria in the blood.
Systemic inflammatory response syndrome: Systemic inflammatory response syndrome (SIRS) is a widespread inflammatory response to a variety of severe clinical insults. This syndrome is clinically recognized by the presence of two or more of the following:
Infection,a documented or suspected, and some of the following:b
Characteristics of the disease
1. Disease has serious consequences
2. Screening population has a high incidence* of disease
3. Risk factor is a good predictor of disease
The diagnostic criteria for tuberous sclerosis complex (TSC) were revised at the Tuberous Sclerosis Complex Consensus Conference, July 1998.
Definite TSC: Two major features or one major feature plus two minor features
Probable TSC: One major feature plus one minor feature
Possible TSC: One major feature or two or more minor features
What Is An Attack?
1980 Criteria for the Classification of Systemic Sclerosis
The American College of Rheumatology (former American Rheumatism Association – ARA) has defined criteria, that are 97 % sensitive and 98 % specific for systemic sclerosis (SSc) as follows:
Major criterion:
Diagnosis
Copyright by MedicalCriteria.com
