Toxic shock: a definition that cannot close
Educational use only. Not clinically reviewed22-year-old woman for calm pattern recognition, activation, bounded treatment intent, open-definition recording, and handoff practice. About 8 simulated minutes.
What you will practise
- Reconcile the erythroderma, early hypotension, and organ involvement.
- Recognize a toxin-mediated pattern without a definition that can close.
- Activate critical care and culture ownership on the pattern.
- Review what a surveillance definition is for.
- Record the definition status openly, with its reason and a re-check horizon.
- Hand off an explicitly open diagnosis.
Review and sources
Not clinically reviewed. No clinician has signed this scenario.
- Centers for Disease Control and Prevention and Council of State and Territorial Epidemiologists. Toxic Shock Syndrome (Other Than Streptococcal), 2011 Case Definition. Fever at or above 38.9 C, diffuse macular erythroderma, desquamation 1 to 2 weeks after onset of rash, systolic blood pressure at or below 90 mmHg, and multisystem involvement in at least 3 of 7 organ systems; laboratory criteria include negative blood and cerebrospinal fluid cultures, with blood permitted to be positive for Staphylococcus aureus. Confirmed requires all 5 clinical findings including desquamation unless the patient dies first.
- Centers for Disease Control and Prevention and Council of State and Territorial Epidemiologists. Streptococcal Toxic Shock Syndrome, 2010 Case Definition. Hypotension plus at least 2 of renal impairment, coagulopathy, hepatic involvement, acute respiratory distress syndrome, generalized erythematous macular rash, or soft-tissue necrosis; confirmed requires isolation of group A Streptococcus from a normally sterile site, probable from a non-sterile site.
- World Health Organization. Increased incidence of scarlet fever and invasive Group A Streptococcus infection, multi-country. Disease Outbreak News, 15 December 2022. The documented international rise changed alerting and contact management rather than the case definitions, which remain at their 2010 and 2011 versions.
Open Sim Lab is an educational simulator, not for clinical use. It is not a clinical decision-support tool, not a dosing calculator, and is not validated for any decision affecting a real patient.