The clinical spectrum of XXXX .

@entity1 @entity8 @entity137 @entity1910 @entity7551 @entity294 @entity649 @entity794 @entity1003 @entity299 @entity854 @entity925 @entity911 @entity2024 @entity551 @entity221 @entity491
@entity137 ( @entity137 ) is a recently recognized acute multisystem illness that may recur. Epidemiologic links with menstruation and use of tampons have been identified. We report the cases of seven @entity1 (six @entity1 and one @entity1 ), 12 to 31 years old, seen over nine months, who met the criteria for @entity137 . Four were menstruating at onset. All had @entity551 , @entity221 , @entity1910 and distal desquamation. A prodrome of @entity925 and @entity294 occurred in all @entity1 . Clinical features of the acute illness included @entity7551 , @entity2024 , @entity491 and @entity8 (7), @entity854 (6), mental @entity911 (6) and @entity1003 (4). In three @entity1 , examination of cerebrospinal fluid showed abnormalities. The illness progressed in three @entity1 to adult @entity649 and significant @entity299 . @entity794 was isolated from mucosal sites in six. The disease recurred in two. There were no deaths. Possible transmissibility was illustrated by two @entity1 , a married couple, with simultaneous illnesses. Pathophysiologic features of @entity137 suggest a toxicogenic cause. Management consists of early recognition, vigorous fluid resuscitation, inotropic support as needed, discontinuation of tampon use and treatment with antistaphylococcal antimicrobic drugs.
