Corticosteroid therapy for patients with toxic shock syndrome

J. K. Todd, M. Ressman, S. A. Caston, B. H. Todd and A. M. Wiesenthal

A comparative retrospective analysis of 45 patients with toxic shock syndrome (TSS) was designed to evaluate the effect of corticosteroid therapy on outcome. All patients satisfied the collaborative strict case definition for TSS, were hospitalized, had shock or postural hypotension, had a potential focus of Staphylococcus aureus infection, and received appropriate antistaphylococcal antimicrobial therapy. Twenty-five patients received corticosteroid therapy during the acute phase of illness and 20 did not. The groups were comparable for age, sex, weight, year of admission, day of illness hospitalized, minimum systolic and diastolic blood pressure, severity of illness, co-intervention with antimicrobials and antipyretics, and amount of intravenous fluid received. Corticosteroid-treated patients had a significantly reduced severity of illness and duration of fever if treated within two to three days of onset of TSS.