Donald B. Nelson

995 VIRAL ASSOCIATIONS OF THE TOXIC-SHOCK SYNDROME (TSS)

34 patients (pts) fulfilling the criteria for the case definition of TSS were evaluated for associated viral infections. 21 pts were cultured from 47 sites: throat (17), stool (16), urine (6), vagina (3), CSF (2), other (3). Herpes Simplex Virus type 1 (HSV1) isolated from two oral and one genital lesion was the only virus demonstrated.Acute and convalescent sera were available for 28 pts. 10 pts (35.7%) had a significant (≥ 4 fold) increase in titer to one or more viruses (Table ). 8 pts had a significant increase in titer to one virus and 2 pts had an increase to each of two viruses. Two pts had primary HSV1 infections documented serologically. One of these pts had a genital HSV1 isolate. 9 additional pts had an acute HSV1 titer of ≥ 1:8; 6/9 were ≥1:32 and 8/9 increased by one dilution. 2/9 pts had an oral HSV1 isolate, 3/9 had ⊖ HSV1 cultures and 4/9 had no cultures. Thus, 13/25 pts (52%) had a primary or recently reactivated HSV1 infection.In conclusion, no viral etiology of TSS was documented but a trend toward HSV1 and CoxB virus infections associated with TSS was demonstrated.