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toxic shock syndrome(TSS). acute, sometimes fatal, disease characterized by high fever, nausea, diarrhea, lethargy, blotchy rash, and sudden drop in blood pressure. It is caused by Staphylococcus aureus, an exotoxin-producing bacteria (see toxintoxin,
poison produced by living organisms. Toxins are classified as either exotoxins or endotoxins. Exotoxins are a diverse group of soluble proteins released into the surrounding tissue by living bacterial cells. Exotoxins have specific reaction sites in the host; e.g.
..... Click the link for more information. ); group A streptococcusstreptococcus
, any of a group of gram-positive bacteria, genus Streptococcus, some of which cause disease. Streptococci are spherical and divide by fission, but they remain attached and so grow in beadlike chains.
..... Click the link for more information. cause a similar disease, called streptococcal toxic shock syndrome or toxic shock-like syndrome. Toxic shock was initially identified among menstruating women using high-absorbency tampons that contained synthetic materials, now no longer used, that bound and removed magnesium from the surrounding bodily environment. The resulting lower magnesium levels encouraged bacterial exotoxin production. Slightly more than half of all cases now occur in menstruating women; nonmenstruating women, men, and children may also develop TSS, as a result of infection after surgery and other causes. Treatment mainly involves supportive measures, such as intravenous fluids and, if necessary, kidney dialysis, but may include antibiotics and immunoglobulin.
Toxic shock syndrome
A serious, sometimes life-threatening disease usually caused by a toxin produced by some strains of the bacterium Staphylococcus aureus. The signs and symptoms are fever, abnormally low blood pressure, nausea and vomiting, diarrhea, muscle tenderness, and a reddish rash, followed by peeling of the skin.
Toxic shock syndrome was first reported in 1978 in seven pediatric patients. However, in 1980 hundreds of cases were reported among young women without apparent staphylococcal infections. Epidemiologists observed that the illness occurred predominantly in young women who were menstruating and were using tampons, especially those that contained so-called superabsorbent synthetic materials. A toxin [toxic shock syndrome toxin number 1 (TSST-1)] that occurs in some strains of staphylococci was later identified. These bacteria are known to proliferate in the presence of foreign particles in human infections, and it has been postulated that the tampons acted as foreign particles, allowing toxin-producing staphylococci to multiply in the vagina.
Several hundred cases of toxic shock syndrome not associated with menstruation have been reported. In these cases, which occurred in males as well as females, there was almost always an overt staphylococcal infection. Susceptibility may depend on lack of antibodies to the toxin that occur in most adults.
The toxin has been shown to occur in only about 1% of the staphylococcal strains studied. Moreover, there is some evidence that the syndrome may be caused also by other staphylococcal toxins, particularly enterotoxins. Cases of toxic shock syndrome that were caused by streptococci have been reported. A toxin distinct from TSST-1 appears involved. Persons with the symptoms of toxic shock syndrome should receive immediate medical care to reduce the chance of death. See Staphylococcus, Toxin