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Staphylococcal toxic shock syndrome

Vivian H Chu, MD, MHS
Section Editors
Daniel J Sexton, MD
Sheldon L Kaplan, MD
Deputy Editor
Elinor L Baron, MD, DTMH


Staphylococcus aureus causes a wide range of infections, from folliculitis and skin abscesses to bacteremia and endocarditis. S. aureus colonizes the skin and mucous membranes of 30 to 50 percent of healthy adults and children, most commonly in the anterior nares, skin, vagina, and rectum [1]. The organism is capable of multiplying in tissues and producing several enzymes that induce inflammation and abscesses. Many strains produce exotoxins that lead to three associated syndromes:

Food poisoning, caused by ingestion of S. aureus enterotoxin

Scalded skin syndrome, caused by exfoliative toxin

Toxic shock syndrome (TSS), caused by toxic shock syndrome toxin-1 (TSST-1) and other enterotoxins [2-5]

Toxic shock syndrome was initially described in 1978 [6]; the disease came to public attention in 1980 with the occurrence of a series of menstrual-associated cases [7]. The majority of clinically reported cases of TSS have been due to methicillin-susceptible S. aureus (MSSA). Cases of TSS due to methicillin-resistant S. aureus (MRSA) have also emerged as rates of infection due to MRSA have increased [8,9].

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Literature review current through: Nov 2017. | This topic last updated: Jun 28, 2017.
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