Most patients also have a fever up to 40 C if significant pulmonary involvement has occurred. Neutrophilic leukocytosis and an elevated erythrocyte sedimentation rate may be observed in SEB intoxication. Toxins may be identified in nasal swabs from persons exposed to respiratory aerosol for at least 12-24 hours, offering an avenue of early diagnosis in the battlefield. Radiographs of the chest appear normal unless the patient has had significant aerosolized exposure, in which case pulmonary edema or an ARDS presentation is evident. Routine abdominal films for SEB gastroenteritis are not necessary but may exhibit significant intestinal gas with no free air.
Treatment is supportive.
In the event of dehydration, vigorous administration of intravenous fluids is indicated. For patients exposed through the pulmonary system, supportive treatment with humidified oxygen and steroids for pain control is all that is usually necessary, although significant exposure may dictate intubation and assisted ventilation with high oxygen concentrations. The efficacy of steroids in SEB-induced pulmonary edema or ARDS has not been demonstrated. Treatment is limited to supportive care, with special attention to elimination of hypotension and hypoxia and pain control as needed. Mechanical ventilation may be required in severe cases.