[abstract] 100% SURVIVAL IN THREE STREPTOCOCCAL TOXIC SHOCK LIKE SYNDROMES AMELIORATED BY ADJUNCTIVE HYPERBARIC OXYGEN.

Abstract

Toxic shock syndrome has been described in certain staphylococcal infections. Streptococcal toxic shock like syndrome is reported less often but is clearly becoming a more frequent clinical problem. Both staphylococcal toxic shock syndrome and streptococcal toxic shock like syndrome have serious morbidity and mortality. In neither case has any research or clinical literature been found reporting use of hyperbaric oxygen in the management of the clinical syndrome. We report three cases of streptococcal toxic shock like syndrome ameliorated by hyperbaric oxygen. Established principles of intensive care, infectious disease, surgery and hyperbaric medicine were successful in securing the patients' survivals. In this series, then, representing the only known group of streptococcal toxic shock like syndromes to be treated with adjunctive hyperbaric oxygen, survival has been 100%. The rational for utilisation of hyperbaric oxygen in such cases includes, but is not limited to, reoxygenation of ischemic - hypoxic tissue, triggering oxygen dependent phagocytic killing and supporting oxygen dependent immune mechanisms. The rational for treatment with hyperbaric oxygen will be described and explored more fully in the presentation. Representative slides of the streptococcal toxic shock like syndrome will be shown.