Toxic Syndromes

Toxic shock syndrome (TSS) is an acute, multisystem, toxin-mediated illness that often results in multiorgan failure. It represents the most fulminant expression of a spectrum of diseases caused by toxin-producing strains of Staphylococcus aureus and Streptococcus pyogenes (group A Streptococcus). The toxins produced by these bacteria possess the ability to act as superantigens, resulting in TSS. Most S. aureus and S. pyogenes infections begin on skin or mucosal surfaces and cause local symptoms due to the direct inflammatory or cytotoxic effects of exotoxins. Despite having a higher mortality rate than that of meningococcal septicemia, TSS is still not well known among healthcare professionals, and in general, few healthcare professionals are able to correctly recognize TSS during the span of their careers. TSS may be encountered anywhere in the healthcare system, from family clinics to specialty hospitals, and its progression of symptoms is so rapid and intense that once seen, it is never forgotten. Therefore, it is essential that all healthcare practitioners have a sound understanding of the clinical features, diagnosis, pathophysiology, and treatment of TSS.