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Vaginal Toxic Shock Reaction Triggering Desquamative Inflammatory Vaginitis

Pereira, Nigel MD1; Edlind, Thomas D. PhD2; Schlievert, Patrick M. PhD3; Nyirjesy, Paul MD1

Journal of Lower Genital Tract Disease: January 2013 - Volume 17 - Issue 1 - p 88–91
doi: 10.1097/LGT.0b013e3182656991

Objective The study aimed to report 2 cases of desquamative inflammatory vaginitis associated with toxic shock syndrome toxin 1 (TSST-1)–producing Staphylococcus aureus strains.

Materials and Methods Case report of 2 patients, 1 with an acute and 1 with a chronic presentation, diagnosed with desquamative inflammatory vaginitis on the basis of clinical findings and wet mount microscopy. Pretreatment and posttreatment vaginal bacterial and yeast cultures were obtained.

Results Pretreatment vaginal bacterial cultures from both patients grew TSST-1–producing S. aureus. Subsequent vaginal bacterial culture results after oral antibiotic therapy were negative.

Conclusions Desquamative inflammatory vaginitis may be triggered through TSST-1–mediated vaginal toxic shock reaction.

Desquamative inflammatory vaginitis may be triggered through toxic shock syndrome toxin 1–mediated vaginal toxic shock reaction.

Departments of 1Obstetrics and Gynecology and 2Microbiology and Immunology, College of Medicine, Drexel University, Philadelphia, PA; and 3Department of Microbiology, Carver College of Medicine, University of Iowa, Iowa City, IA

Reprint requests to: Nigel Pereira, MD, Department of Obstetrics and Gynecology, Drexel University College of Medicine, 245 N. 15th St, MS 495, 16th Floor, New College Bldg, Philadelphia, PA 19102. E-mail:

Patrick M. Schlievert was funded by USPHS research grants AI-74283 and AI57153 from the NIH-supported Great Lakes Regional Center for Excellence in Biodefense and Emerging Diseases of which he is a member. For the remaining authors, none were declared.

©2013The American Society for Colposcopy and Cervical Pathology