Toxic shock syndrome causes
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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 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
** 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 approximately 20% almost never carry S. aureus. [2]
Group A streptococcus associated Toxic shock syndrome
** 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 stretococcal 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 part of the normal flora of the vagina and may gain entry to 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, childbirth, 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.