Toxic shock syndrome causes: Difference between revisions
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==Overview== | ==Overview== | ||
Toxic shock syndrome (TSS) is known to be caused by intoxication of one of the various [[exotoxins]] produced by [[Staphylococcus aureus|''Staphylococcus aureus'']], namely Toxic shock syndrome toxin-1 (TSST-1). It may also be caused by some strains of [[Group A streptococcal infection|''Group A streptococcal'']] (GAS) infection. There have been reports of TSS caused by [[Clostridium perfringens|''Clostridium perfringens'']] and [[Clostridium sordellii|''Clostridium sordelli'']] in women undergoing medical abortion, parturition and gynaecological procedures.<sup>[[Toxic shock syndrome pathophysiology|[1][2][3][4][5]]]</sup> | Toxic shock syndrome (TSS) is known to be caused by intoxication of one of the various [[exotoxins]] produced by [[Staphylococcus aureus|''Staphylococcus aureus'']], namely Toxic shock syndrome toxin-1 (TSST-1). It may also be caused by some strains of [[Group A streptococcal infection|''Group A streptococcal'']] (GAS) infection. There have been reports of TSS caused by [[Clostridium perfringens|''Clostridium perfringens'']] and [[Clostridium sordellii|''Clostridium sordelli'']] in women undergoing medical abortion, [[parturition]] and gynaecological procedures.<sup>[[Toxic shock syndrome pathophysiology|[1][2][3][4][5]]]</sup> | ||
=== Causes of Toxic shock syndrome === | === Causes of Toxic shock syndrome === | ||
==== '''Staphylococcus associated Toxic shock syndrome (TSS)''' ==== | ==== '''Staphylococcus associated Toxic shock syndrome (TSS)''' ==== | ||
* ''Staphylococcus aureus'', a gram positive coccus has been known to be a major cause of Toxic shock syndrome via the production and intoxication by Toxic shock syndrome toxin-1 (TSST-1). | * ''[[Staphylococcus aureus]]'', a [[Gram-positive bacteria|gram positive]] [[coccus]] has been known to be a major cause of Toxic shock syndrome via the production and intoxication by Toxic shock syndrome toxin-1 (TSST-1). | ||
* A new staphylococcal enterotoxin, enterotoxin F, has also been associated with Toxic shock syndrome (TSS).<ref name="pmid6112412">{{cite journal |vauthors=Bergdoll MS, Crass BA, Reiser RF, Robbins RN, Davis JP |title=A new staphylococcal enterotoxin, enterotoxin F, associated with toxic-shock-syndrome Staphylococcus aureus isolates |journal=Lancet |volume=1 |issue=8228 |pages=1017–21 |year=1981 |pmid=6112412 |doi= |url=}}</ref> | * A new staphylococcal [[enterotoxin]], enterotoxin F, has also been associated with Toxic shock syndrome (TSS).<ref name="pmid6112412">{{cite journal |vauthors=Bergdoll MS, Crass BA, Reiser RF, Robbins RN, Davis JP |title=A new staphylococcal enterotoxin, enterotoxin F, associated with toxic-shock-syndrome Staphylococcus aureus isolates |journal=Lancet |volume=1 |issue=8228 |pages=1017–21 |year=1981 |pmid=6112412 |doi= |url=}}</ref> | ||
* S. aureus colonizes the anterior nares and vagina of humans. About 20% of people are persistent carriers, 60% are intermittent carriers, and | * ''[[Staphylococcus aureus|S. aureus]]'' colonizes the anterior nares and vagina of humans. About 20% of people are persistent carriers, 60% are intermittent carriers, and about 20% are almost never colonized by [[Staphylococcus aureus|''S. aureus'']]. <ref name="pmid9227864">{{cite journal |vauthors=Kluytmans J, van Belkum A, Verbrugh H |title=Nasal carriage of Staphylococcus aureus: epidemiology, underlying mechanisms, and associated risks |journal=Clin. Microbiol. Rev. |volume=10 |issue=3 |pages=505–20 |year=1997 |pmid=9227864 |pmc=172932 |doi= |url=}}</ref> | ||
==== Group A streptococcus associated Toxic shock syndrome (Toxic sock-like syndrome, TSLS) ==== | ==== Group A streptococcus associated Toxic shock syndrome (Toxic sock-like syndrome, TSLS) ==== | ||
* Streptococcal TSS occurs most frequently in the setting of invasive infection due to group A ''Streptococcus'' (''Streptococcus pyogenes''). | * [[Streptococcus|Streptococcal]] TSS occurs most frequently in the setting of invasive infection due to group A ''Streptococcus'' (''[[Streptococcus pyogenes]]''). | ||
* Toxic shock syndrome has been seen as a complication in patients suffering from | * Toxic shock syndrome has been seen as a complication in patients suffering from streptococcal [[pharyngitis]] and [[necrotizing fasciitis]].<ref name="pmid2659990">{{cite journal |vauthors=Stevens DL, Tanner MH, Winship J, Swarts R, Ries KM, Schlievert PM, Kaplan E |title=Severe group A streptococcal infections associated with a toxic shock-like syndrome and scarlet fever toxin A |journal=N. Engl. J. Med. |volume=321 |issue=1 |pages=1–7 |year=1989 |pmid=2659990 |doi=10.1056/NEJM198907063210101 |url=}}</ref> | ||
* There have been reports of TSS in patients taking | * There have been reports of TSS in patients taking [[Non-steroidal anti-inflammatory drug|NSAID]]<nowiki/>s during infection by GAS. The possible mechanism that has been proposed, is inhibition of [[neutrophil]] function and increased [[cytokine]] production. <ref name="pmid8645850">{{cite journal |vauthors=Stevens DL |title=Could nonsteroidal antiinflammatory drugs (NSAIDs) enhance the progression of bacterial infections to toxic shock syndrome? |journal=Clin. Infect. Dis. |volume=21 |issue=4 |pages=977–80 |year=1995 |pmid=8645850 |doi= |url=}}</ref> | ||
==== Clostridium associated Toxic shock syndrome ==== | ==== Clostridium associated Toxic shock syndrome ==== | ||
* ''Clostridium sordellii'' is part of the normal flora of the vagina and may gain entry | * ''[[Clostridium sordellii]]'' is a part of the normal flora of the vagina and may gain entry into the [[uterus]] via the [[cervix]] during spontaneous or induced [[abortion]], childbirth, or [[menstruation]]. ''C. sordellii'' is a cause of toxic shock syndrome associated with gynecologic procedures, parturition, and abortion (including spontaneous, surgical, and medical abortion). | ||
{{reflist|2}} | {{reflist|2}} | ||
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Overview
Toxic shock syndrome (TSS) is known to be caused by intoxication of one of the various exotoxins produced by Staphylococcus aureus, namely Toxic shock syndrome toxin-1 (TSST-1). It may also be caused by some strains of Group A streptococcal (GAS) infection. There have been reports of TSS caused by Clostridium perfringens and Clostridium sordelli in women undergoing medical abortion, parturition and gynaecological procedures.[1][2][3][4][5]
Causes of Toxic shock syndrome
Staphylococcus associated Toxic shock syndrome (TSS)
- Staphylococcus aureus, a gram positive coccus has been known to be a major cause of Toxic shock syndrome via the production and intoxication by Toxic shock syndrome toxin-1 (TSST-1).
- A new staphylococcal enterotoxin, enterotoxin F, has also been associated with Toxic shock syndrome (TSS).[1]
- S. aureus colonizes the anterior nares and vagina of humans. About 20% of people are persistent carriers, 60% are intermittent carriers, and about 20% are almost never colonized by S. aureus. [2]
Group A streptococcus associated Toxic shock syndrome (Toxic sock-like syndrome, TSLS)
- Streptococcal TSS occurs most frequently in the setting of invasive infection due to group A Streptococcus (Streptococcus pyogenes).
- Toxic shock syndrome has been seen as a complication in patients suffering from streptococcal pharyngitis and necrotizing fasciitis.[3]
- There have been reports of TSS in patients taking NSAIDs during infection by GAS. The possible mechanism that has been proposed, is inhibition of neutrophil function and increased cytokine production. [4]
Clostridium associated Toxic shock syndrome
- Clostridium sordellii is a part of the normal flora of the vagina and may gain entry into the uterus via the cervix during spontaneous or induced abortion, childbirth, or menstruation. C. sordellii is a cause of toxic shock syndrome associated with gynecologic procedures, parturition, and abortion (including spontaneous, surgical, and medical abortion).
- ↑ Bergdoll MS, Crass BA, Reiser RF, Robbins RN, Davis JP (1981). "A new staphylococcal enterotoxin, enterotoxin F, associated with toxic-shock-syndrome Staphylococcus aureus isolates". Lancet. 1 (8228): 1017–21. PMID 6112412.
- ↑ Kluytmans J, van Belkum A, Verbrugh H (1997). "Nasal carriage of Staphylococcus aureus: epidemiology, underlying mechanisms, and associated risks". Clin. Microbiol. Rev. 10 (3): 505–20. PMC 172932. PMID 9227864.
- ↑ Stevens DL, Tanner MH, Winship J, Swarts R, Ries KM, Schlievert PM, Kaplan E (1989). "Severe group A streptococcal infections associated with a toxic shock-like syndrome and scarlet fever toxin A". N. Engl. J. Med. 321 (1): 1–7. doi:10.1056/NEJM198907063210101. PMID 2659990.
- ↑ Stevens DL (1995). "Could nonsteroidal antiinflammatory drugs (NSAIDs) enhance the progression of bacterial infections to toxic shock syndrome?". Clin. Infect. Dis. 21 (4): 977–80. PMID 8645850.