Toxic Shock Syndrome: A Health Professional’s Guide

Written by Robert L Deresiewicz

Staphylococcal toxic shock syndrome (TSS) is a rare, life-threatening systemic bacterial intoxication. It occurs in diverse clinical settings, often mimicking more common febrile conditions. With early treatment, the serious consequences of TSS (organ failure, limb loss, death) can often be avoided. The diagnosis rests exclusively on clinical grounds and, while often readily established, it must first be considered. Accordingly, health professionals should be familiar with the manifestations of TSS, and should vigilantly consider the diagnosis in appropriate clinical settings.

What is TSS?

TSS is an acute, noncontagious systemic illness characterised by high fever, hypotension, rash, multi-organ dysfunction, and cutaneous desquamation during the early convalescent period (Table 1). It is caused by any of several related staphylococcal exotoxins. The exotoxins of S. aureus are proteinaceous compounds that are secreted at certain times during bacterial growth. The most common TSS toxins are toxic shock syndrome toxin-1 (TSST-1; ~75 percent of cases) and staphylococcal enterotoxin B (SEB; 20-25 percent of cases).

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DECORATION.

Staphylococcus aureus bacteria from a group that is resistant to antibiotics. Some of them are dividing to reproduce.

DR KARI LOUNATMAA / SCIENCE PHOTO LIBRARY