toxic shock syndrome
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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