Toxic shock syndrome causes: Difference between revisions
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==Overview== | ==Overview== | ||
Toxic shock syndrome (TSS) is known to be caused by | [[Toxic shock syndrome]] ([[Toxic shock syndrome|TSS]]) is known to be caused due to intoxication by 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. <ref name="pmid24816557">{{cite journal |vauthors=Kulhankova K, King J, Salgado-Pabón W |title=Staphylococcal toxic shock syndrome: superantigen-mediated enhancement of endotoxin shock and adaptive immune suppression |journal=Immunol. Res. |volume=59 |issue=1-3 |pages=182–7 |year=2014 |pmid=24816557 |doi=10.1007/s12026-014-8538-8 |url=}}</ref> 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 == | == Causes == | ||
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=== Causes of Toxic shock syndrome === | === Causes of Toxic shock syndrome === | ||
==== '''Staphylococcus associated Toxic shock syndrome (TSS)''' ==== | ==== Common causes: ==== | ||
* ''[[Staphylococcus aureus]]'', a [[Gram-positive bacteria|gram positive]] [[coccus]] has been known to be a major cause of | |||
===== '''Staphylococcus associated Toxic shock syndrome (TSS)''' ===== | |||
* ''[[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). <ref name="pmid248165572">{{cite journal |vauthors=Kulhankova K, King J, Salgado-Pabón W |title=Staphylococcal toxic shock syndrome: superantigen-mediated enhancement of endotoxin shock and adaptive immune suppression |journal=Immunol. Res. |volume=59 |issue=1-3 |pages=182–7 |year=2014 |pmid=24816557 |doi=10.1007/s12026-014-8538-8 |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> | ** 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> | ||
** ''[[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> | ** ''[[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) ===== | ||
* [[Streptococcus|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]]''). <ref name="pmid248165573">{{cite journal |vauthors=Kulhankova K, King J, Salgado-Pabón W |title=Staphylococcal toxic shock syndrome: superantigen-mediated enhancement of endotoxin shock and adaptive immune suppression |journal=Immunol. Res. |volume=59 |issue=1-3 |pages=182–7 |year=2014 |pmid=24816557 |doi=10.1007/s12026-014-8538-8 |url=}}</ref> | ||
* 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> | * 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> | ||
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* 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> | * 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 ==== | ==== Less common causes: ==== | ||
===== 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). | * ''[[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). | ||
==== Other causes ==== | ==== Other causes ==== | ||
* Toxic shock syndrome can also develop secondary to viral infection, such as influenza or chickenpox. | * Toxic shock syndrome can also develop secondary to viral infection, such as influenza or chickenpox. <ref name="pmid8353244">{{cite journal |vauthors=Tolan RW |title=Toxic shock syndrome complicating influenza A in a child: case report and review |journal=Clin. Infect. Dis. |volume=17 |issue=1 |pages=43–5 |year=1993 |pmid=8353244 |doi= |url=}}</ref> | ||
== References == | == References == | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Toxic shock syndrome (TSS) is known to be caused due to intoxication by 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. [1] 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
Causes of Toxic shock syndrome
Common causes:
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). [2]
- A new staphylococcal enterotoxin, enterotoxin F, has also been associated with Toxic shock syndrome (TSS).[3]
- 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. [4]
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). [5]
- Toxic shock syndrome has been seen as a complication in patients suffering from streptococcal pharyngitis and necrotizing fasciitis.[6]
- 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. [7]
Less common causes:
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).
Other causes
- Toxic shock syndrome can also develop secondary to viral infection, such as influenza or chickenpox. [8]
References
- ↑ Kulhankova K, King J, Salgado-Pabón W (2014). "Staphylococcal toxic shock syndrome: superantigen-mediated enhancement of endotoxin shock and adaptive immune suppression". Immunol. Res. 59 (1–3): 182–7. doi:10.1007/s12026-014-8538-8. PMID 24816557.
- ↑ Kulhankova K, King J, Salgado-Pabón W (2014). "Staphylococcal toxic shock syndrome: superantigen-mediated enhancement of endotoxin shock and adaptive immune suppression". Immunol. Res. 59 (1–3): 182–7. doi:10.1007/s12026-014-8538-8. PMID 24816557.
- ↑ 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.
- ↑ Kulhankova K, King J, Salgado-Pabón W (2014). "Staphylococcal toxic shock syndrome: superantigen-mediated enhancement of endotoxin shock and adaptive immune suppression". Immunol. Res. 59 (1–3): 182–7. doi:10.1007/s12026-014-8538-8. PMID 24816557.
- ↑ 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.
- ↑ Tolan RW (1993). "Toxic shock syndrome complicating influenza A in a child: case report and review". Clin. Infect. Dis. 17 (1): 43–5. PMID 8353244.