Diagnostic value of Vβ2-positive T-cell expansion in toxic shock syndrome

Background  diagnostic dilemma in toxic shock syndrome (TSS) is that the results of microbiologic investigations are often not available immediately because of the need for incubation, or no obvious entry point can be found. Methods  We describe three patients with a clinical diagnosis of TSS in whom microbiologic tests were negative. Results  All patients had complicated courses with vasopressor-dependent shock, renal and respiratory failure, and disseminated intravascular coagulation for at least 1 week. In all three patients, diagnosis was considerably faster with the assessment of the expansion of T-cell-receptor Vβ2-positive T cells (> 15%) than by Centers for Disease Control and Prevention (CDC) diagnosis, because of the complicated clinical picture or the delay caused by waiting for the results of microbiologic investigations. Conclusions  Our results indicate that diagnostic procedures incorporating Vβ2-positive T cells could be a useful tool for the diagnosis of TSS.