ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2009
Intravenous immunoglobulin in children with streptococcal toxic shock syndrome.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 48 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
48 citing papers in PubMed, 2 syntheses or guidelines pooled it, 143 citations in OpenAlex.
- Prognostic factors for streptococcal toxic shock syndrome: systematic review and meta-analysis.BMJ open · 2022Pooled it
- Polyspecific Intravenous Immunoglobulin in Clindamycin-treated Patients With Streptococcal Toxic Shock Syndrome: A Systematic Review and Meta-analysis.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2018Pooled it
- High-dose intravenous immunoglobulin versus albumin 4% in paediatric toxic shock syndrome: a randomised controlled feasibility study.Archives of disease in childhood · 2024Trial
- Intravenous Immunoglobulin Treatment in Patients With Streptococcal Toxic Shock Syndrome in Southern Sweden: A Retrospective Population-Based Study.Open forum infectious diseases · 2026Article
- Clindamycin and intravenous immunoglobulins in pediatric invasive group A streptococcal disease: what is the evidence?European journal of pediatrics · 2026Review
- Clinical features and trends of severe paediatric group A streptococcal infections in Japan in the post-COVID-19 pandemic era.Epidemiology and infection · 2026Article
- Evolving treatment strategies for invasive Streptococcus pyogenes in children in the postpandemic era.Clinical and experimental pediatrics · 2025Article
- Optimizing Antibiotic Choice, Administration, and Duration in NSTI Treatment.Bioengineering (Basel, Switzerland) · 2025Review
- Immunomodulation in Pediatric Sepsis: A Narrative Review.Journal of clinical medicine · 2025Review
- Probabilistic Graphical Models for Evaluating the Utility of Data-Driven ICD Code Categories in Pediatric Sepsis.AMIA ... Annual Symposium proceedings. AMIA Symposium · 2024Article
- Clinical Profile, Intensive Care Needs, and Short-Term Outcome of Toxic Shock Syndrome Among Children: A 10-Year Single-Centre Experience from North India.Indian journal of pediatrics · 2023Article
- Clinical Efficacy of Intravenous Immunoglobulins in Management of Toxic Shock Syndrome: An Updated Literature Review.Cureus · 2021Review
- Invasive Group A Streptococcal Infections: Benefit of Clindamycin, Intravenous Immunoglobulins and Secondary Prophylaxis.Frontiers in pediatrics · 2021Review
- Playing With Fire: Proinflammatory Virulence Mechanisms of Group AFrontiers in cellular and infection microbiology · 2021Review
- Manifestations of Toxic Shock Syndrome in Children, Columbus, Ohio, USA, 2010-2017Emerging infectious diseases · 2020Article
- 2018 WSES/SIS-E consensus conference: recommendations for the management of skin and soft-tissue infections.World journal of emergency surgery : WJES · 2018Review
- Similarities and Differences Between Staphylococcal and Streptococcal Toxic Shock Syndromes in Children: Results From a 30-Case Cohort.Frontiers in pediatrics · 2018Article
- Secular trends in incidence of invasive beta-hemolytic streptococci and efficacy of adjunctive therapy in Quebec, Canada, 1996-2016.PloS one · 2018Article
- Therapeutic targets in necrotizing soft tissue infections.Intensive care medicine · 2017Article
- Evaluation and Management of Necrotizing Soft Tissue Infections.Infectious disease clinics of North America · 2017Review
Corrections and comments
- Commented on by
Authors and funding
5 authors at 5 institutions in 1 country.
Funding
Abstract
backgroundStreptococcal toxic shock syndrome (TSS) is a rare and severe manifestation of group A streptococcal infection. The role of intravenous immunoglobulin (IVIG) for streptococcal TSS in children is controversial. This study aims to describe the epidemiology of streptococcal TSS in children and to determine whether adjunctive therapy with IVIG is associated with improved outcomes.
methodsA multicenter, retrospective cohort study of children with streptococcal TSS from 1 January 2003 through 31 December 2007 was conducted. Propensity scores were used to determine each child's likelihood of receiving IVIG. Differences in the primary outcomes of death, hospital length of stay, and total hospital costs were compared after matching IVIG recipients and nonrecipients on propensity score.
resultsThe median patient age was 8.2 years. IVIG was administered to 84 (44%) of 192 patients. The overall mortality rate was 4.2% (95% confidence interval, 1.8%-8.0%). Differences in mortality between IVIG recipients (n = 3; 4.5%) and nonrecipients (n = 3; 4.5%) were not statistically significant (p > .99). Although patients receiving IVIG had higher total hospital and drug costs than nonrecipients, differences in hospital costs were not significant once drug costs were removed (median difference between matched patients, $6139; interquartile range, -$8316 to $25,993; P = .06). No differences were found in length of hospital stay between matched IVIG recipients and nonrecipients.
conclusionThis multicenter study is, to our knowledge, the largest to describe the epidemiology and outcomes of children with streptococcal TSS and the first to explore the association between IVIG use and clinical outcomes. IVIG use was associated with increased costs of caring for children with streptococcal TSS but was not associated with improved outcomes.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.