Indian Journal of Critical Care Medicine

Register      Login

SEARCH WITHIN CONTENT

FIND ARTICLE

Volume / Issue

Online First

Archive
Related articles

VOLUME 14 , ISSUE 3 ( July, 2010 ) > List of Articles

CASE REPORT

Use of recombinant human activated protein C in nonmenstrual staphylococcal toxic shock syndrome

Prashant Nasa, Deepak Sehrawat

Keywords : Nonmenstrual toxic shock syndrome, recombinant human activated protein C, staphyloccocal exotoxin, staphylococcal toxic shock syndrome.

Citation Information : Nasa P, Sehrawat D. Use of recombinant human activated protein C in nonmenstrual staphylococcal toxic shock syndrome. Indian J Crit Care Med 2010; 14 (3):147-150.

DOI: 10.4103/0972-5229.74174

License: CC BY-ND 3.0

Published Online: 00-07-2010

Copyright Statement:  Copyright © 2010; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Toxic shock syndrome (TSS) is a serious, potentially life-threatening condition resulting from an overwhelming immunological response to an exotoxin released by Staphylococcus aureus and group A streptococci. High index of suspicion, early diagnosis and aggressive therapeutic measures must be instituted in view of high mortality of the TSS. In recent years, new agents have been tested to reduce morbidity and mortality in patients with severe sepsis, in addition to standard supportive measures. Among them, recombinant human activated protein C (rhAPC) has been reported to significantly reduce mortality and morbidity in patients with severe sepsis and two or more acute organ failures. We describe our experience with this drug in the early reversal of septic shock from TSS.


PDF Share
  1. Dellinger RP, Levy MM, Carlet JM, Bion J, Parker MM, Jaeschke R, et al. Surviving Sepsis Campaign: International guidelines for management of severe sepsis and septic shock. Crit Care Med 2008;36:296-327.
  2. Todd JK. Toxic shock syndrome. Clin Microbiol Rev 1988;1:432-46.
  3. Parsonnet J, Hickman RK, Eardley DD, Pier GB. Induction of human interleukin-1 by Toxic shock syndrome toxin-1. J Infect Dis 1985;151:514.
  4. Centers for Disease Control and Prevention (CDC).Toxic-shock syndrome–United States 1980. MMWR Morb Mortal Wkly Rep 1997;46:492-3.
  5. Calandra T, Cohen J. International Sepsis Forum Definition of Infection in the ICU Consensus Conference. The international sepsis forum consensus conference on definitions of infection in the intensive care unit. Crit Care Med 2005;33:1538-48.
  6. Levy MM, Pronovost PJ, Dellinger RP, Townsend S, Resar RK, Clemmer TP, et al. Sepsis change bundles: converting guidelines into meaningful change in behavior and clinical outcome. Crit Care Med 2004;32:S595-S597.
  7. Mascini EM, Jansze M, Schouls LM, Verhoef J, Van Dijk H. Penicillin and clindamycin differentially inhibit the production of pyrogenic exotoxins A and B by group A streptococci. Int J Antimicrob Agents 2001;18:395-8.
  8. Cone LA, Stone RA, Schlievert PM, Sneider RA, Rubin AM, Jesser K, et al. An early favorable outcome of streptococcal toxic shock syndrome may require a combination of antimicrobial and intravenous gamma globulin therapy together with activated protein C. Scand J Infect Dis 2006;38:960-3.
  9. Ellies E, Mari A, Silva S, Bauriaud R, Fourcade O, Genestal M. Toxic shock syndrome consecutive to the presence of vaginal tampon for menstruation regressive after early haemodynamic optimization and activated protein C infusion. Ann Fr Anesth Reanim 2009;28:91-5.
  10. Rachakonda KS. Activated Protein C in Toxic Shock Syndrome: A Case Report. Crit Care Resusc 2003;5:189-92.
  11. Haddadin DW, Samnani IQ, Moorman JP. Drotrecogin Alfa (Activated) for Nonmenstrual Toxic Shock Syndrome Associated with Methicillin Resistant Staphylococcus aureus Infection. South Med J 2006;99:1295-6.
  12. Bernard GR, Vincent JL, Laterre PF, LaRosa SP, Dhainaut JF, Lopez-Rodriguez A, et al. Efficacy and Safety of recombinant human activated protein C for severe sepsis. N Eng J Med 2001;344:699-709.
  13. Levi M, Poll T. Recombinant human activated protein C: current insights into its mechanism of action. Crit Care 2007;11:S3.
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.