Overview
Toxic shock syndrome (TSS) describes fever, skin rash, and shock due to toxins from bacteria, including Staphylococcus aureus (known as staphylococcal TSS). Staphylococcus aureus can produce the TSST-1 toxin, a superantigen, resulting in intense T-cell activation and massive cytokine production.
In the 1980s, some people had left tampons in for long times, resulting in bacterial growth and infection, resulting in TSS.
Presentation
Features of staphylococcal TSS include:
- Fever and features of shock (hypotension, tachycardia)
- Skin lesions – erythroderma, desquamation of the palms and soles, ulceration, and mucosal involvement
- Other organ involvement – including gastrointestinal (e.g. diarrhoea/vomiting), neurologic (e.g. seizures), and renal failure
Management
Overview
Management involves removing the infective source (e.g. a retained tampon), intravenous fluids, and intravenous antibiotics.
