Toxic shock syndrome causes
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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.