Toxic shock syndrome

• Published in: Primary care update for Ob/Gyns Vol. 7; no. 3; pp. 85 - 90
• Main Author: Reiss, Martina Afshar
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.05.2000
• ISSN: 1068-607X; 1878-4283
• DOI: 10.1016/S1068-607X(00)00027-5

Toxic shock syndrome (TSS) is an acute febrile illness accompanied by watery diarrhea, sunburn rash, vomiting, hypotension, and multiple organ involvement. When it was initially recognized 20 years ago, TSS was primarily associated with menstruation. Since then, the frequency of menstrual TSS has decreased dramatically. Staphylococcus aureus is the cause of menstrual TSS and is also responsible for about half of all cases of nonmenstrual TSS. Since the late 1980s, Streptococcus pyogenes has been shown to cause a nonmenstrual TSS-like illness, with a higher mortality rate. The mechanism of TSS is attributable to bacterial endotoxins that impede the body’s immune system and cause the release of cytokines, which are responsible for the clinical manifestations of the disease. Early recognition and treatment of TSS are important factors in improving patient survival. Patients should be treated with parenteral antibiotics that are highly effective against staphylococci and streptococci. They should also receive fluid resuscitation and vasopressors. Some patients require intubation, dialysis, or immunoglobulin therapy.