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Toxic shock syndrome 

Toxic shock syndrome
Chapter:
Toxic shock syndrome
DOI:
10.1093/med/9780198729228.003.0036
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date: 17 June 2019

Bites in children are frequent and most commonly due to dogs. Infectious complications can occur from all types of bites, but cat bites and hand wounds are more likely to become infected. Following a careful assessment, the important issues include cleaning and debriding the wound, consideration of prophylactic antibiotics, treatment of any infections, and appropriate tetanus pre-emptive measures. Burns also commonly occur in children, varying from superficial scalds to full-thickness and life-threatening conditions. Prophylactic antibiotics are not routinely recommended. The depth, location, and size of the burn are important features, as these have a bearing on the healing process and the need for involvement of specialists, such as plastic burns surgeons, and their teams. Full-thickness burns, fire injuries, and burns over 30% of surface area are more likely to become infected. Large burns (over 30%) may also cause significant immunosuppression. Infection can be a difficult diagnosis in children with burns, as they usually have a high white cell count and C-reactive protein and nearly all children with a serious burn have a high fever, often for a week or longer. The classical signs of burn wound infection are local signs of inflammation or a purulent exudate, with or without clinical signs of sepsis syndrome.

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