{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T16:40:01Z","timestamp":1756744801168,"version":"3.44.0"},"reference-count":23,"publisher":"BMJ","issue":"9","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,8,11]]},"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:p>This report describes the occurrence of toxic shock syndrome in a teenage girl. She presented with fever, rash, vomiting, dyspnoea and drowsiness. Examination showed a strawberry tongue and suppurative lymphadenitis in the right axilla with hypotensive shock. Abdominal examination confirmed hepatomegaly. Laboratory evaluation confirmed sepsis. The clinical presentation and evaluation suggested the possibility of toxic shock syndrome (TSS). Culture of her axillary lymph node abscess was positive for <jats:italic>Acinetobacter baumannii<\/jats:italic>. The child was managed with supportive therapy including high flow oxygen, fluid resuscitation, inotropes and antibiotics. She recovered within a week and was reviewed 1\u2009week later. She was found to have skin desquamation on her palms and soles. TSS should be considered in the differential diagnosis in a child presenting with fever, rash and hypotension. It requires thorough examination and evaluation to identify the condition and focus of infection and prompt aggressive management which can bring best outcomes.<\/jats:p>","DOI":"10.1136\/bcr-2024-264010","type":"journal-article","created":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T16:00:11Z","timestamp":1756742411000},"page":"e264010","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Toxic shock syndrome complicated by co-infection with multidrug-resistant <i>Acinetobacter baumannii<\/i>"],"prefix":"10.1136","volume":"18","author":[{"given":"Ananya","family":"P","sequence":"first","affiliation":[{"name":"Pediatrics, BLDE Deemed to be University, Vijayapura, Karnataka, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Prakash Vemanna","family":"J","sequence":"additional","affiliation":[{"name":"Pediatrics, BLDE Deemed to be University, Vijayapura, Karnataka, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,9,1]]},"reference":[{"key":"2025090109000618000_18.9.e264010.1","doi-asserted-by":"crossref","DOI":"10.12688\/f1000research.15758.1","article-title":"Recent advances in understanding and managing sepsis","volume":"7","author":"Berg","year":"2018","journal-title":"F1000Res"},{"key":"2025090109000618000_18.9.e264010.2","doi-asserted-by":"crossref","first-page":"600","DOI":"10.1097\/QCO.0000000000000492","article-title":"Current management of Gram-negative septic shock","volume":"31","author":"Vincent","year":"2018","journal-title":"Curr Opin Infect Dis"},{"key":"2025090109000618000_18.9.e264010.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccc.2013.03.012"},{"key":"2025090109000618000_18.9.e264010.4","doi-asserted-by":"crossref","first-page":"1334","DOI":"10.1097\/CCM.0000000000003225","article-title":"Surviving Sepsis Campaign: Research Priorities for Sepsis and Septic Shock","volume":"46","author":"Coopersmith","year":"2018","journal-title":"Crit Care Med"},{"key":"2025090109000618000_18.9.e264010.5","doi-asserted-by":"crossref","DOI":"10.1186\/s13613-018-0438-y","article-title":"Streptococcal toxic shock syndrome in the intensive care unit","volume":"8","author":"Schmitz","year":"2018","journal-title":"Ann Intensive Care"},{"key":"2025090109000618000_18.9.e264010.6","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00422-08"},{"key":"2025090109000618000_18.9.e264010.7","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.9.2.148"},{"key":"2025090109000618000_18.9.e264010.8","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-0691.2005.01227.x"},{"key":"2025090109000618000_18.9.e264010.9","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.39.1.228-234.2001"},{"key":"2025090109000618000_18.9.e264010.10","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1007\/s12098-022-04271-4","article-title":"Clinical Profile, Intensive Care Needs, and Short-Term Outcome of Toxic Shock Syndrome Among Children: A 10-Year Single-Centre Experience from North India","volume":"90","author":"Angurana","year":"2023","journal-title":"Indian J Pediatr"},{"key":"2025090109000618000_18.9.e264010.11","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2013-304741"},{"key":"2025090109000618000_18.9.e264010.12","first-page":"11","article-title":"Toxic Shock Syndrome in Children Epidemiology, Pathogenesis, and Management","volume":"7","author":"Chuang","year":"2005","journal-title":"THERAPY IN PRACTICE"},{"key":"2025090109000618000_18.9.e264010.13","doi-asserted-by":"publisher","DOI":"10.1086\/500265"},{"key":"2025090109000618000_18.9.e264010.14","first-page":"38247655","article-title":"Toxic Shock Syndrome: A Literature Review","volume":"13","author":"Atchade","year":"2024","journal-title":"Antibiotics (Basel)"},{"key":"2025090109000618000_18.9.e264010.15","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1016\/j.jemermed.2010.05.031","article-title":"Serious infectious complications related to extremity cast\/splint placement in children","volume":"41","author":"Delasobera","year":"2011","journal-title":"J Emerg Med"},{"key":"2025090109000618000_18.9.e264010.16","doi-asserted-by":"crossref","unstructured":"Chu VH . Staphylococcal toxic shock syndrome. 2015. doi:10.1155\/2015\/640373","DOI":"10.1155\/2015\/640373"},{"key":"2025090109000618000_18.9.e264010.17","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00058-07"},{"key":"2025090109000618000_18.9.e264010.18","doi-asserted-by":"publisher","DOI":"10.1089\/sur.2009.022"},{"key":"2025090109000618000_18.9.e264010.19","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1086\/502205","article-title":"Acinetobacter outbreaks, 1977 2000","volume":"24","author":"Villegas","year":"1977","journal-title":"Infect Control Hosp Epidemiol"},{"key":"2025090109000618000_18.9.e264010.20","doi-asserted-by":"publisher","DOI":"10.1086\/518170"},{"key":"2025090109000618000_18.9.e264010.21","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra070741"},{"key":"2025090109000618000_18.9.e264010.22","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-96-6-858"},{"key":"2025090109000618000_18.9.e264010.23","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-96-6-852"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2024-264010","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T16:00:13Z","timestamp":1756742413000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2024-264010"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9]]},"references-count":23,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2025,9,1]]},"published-print":{"date-parts":[[2025,9]]}},"alternative-id":["10.1136\/bcr-2024-264010"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2024-264010","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9]]}}}