Skip to main content Accessibility help
×
Hostname: page-component-586b7cd67f-2brh9 Total loading time: 0 Render date: 2024-11-26T16:07:52.112Z Has data issue: false hasContentIssue false

18 - Staphylococcal and Streptococcal Toxic Shock and Kawasaki Syndromes

from Part IV - Clinical Syndromes – Skin and Lymph Nodes

Published online by Cambridge University Press:  05 March 2013

Aristides P. Assimacopoulos
Affiliation:
University of South Dakota
Patrick M. Schlievert
Affiliation:
University of Minnesota Medical School
David Schlossberg
Affiliation:
Temple University School of Medicine, Philadelphia
Get access

Summary

TOXIC SHOCK SYNDROME

Staphylococcal and streptococcal toxic shock syndromes (TSS) are acute-onset multiorgan illnesses defined by the criteria listed in Tables 18.1 and 18.2. Staphylococcal TSS is caused by Staphylococcus aureus strains that make pyrogenic toxin superantigens (PTSAgs); coagulase-negative strains do not make the causative toxins. Streptococcal TSS is caused mainly by toxin-producing group A strains but occasionally by groups B, C, F, and G strains. Several subsets of staphylococcal TSS exist, with two major categories being menstrual and nonmenstrual.

Menstrual TSS (Figure 18.1), which occurs within a day or two of and during menstruation, primarily has been associated with use of certain tampons, notably those of high absorbency, and is associated with production of TSS toxin-1 (TSST-1) by the causative bacterium. Three theories have been proposed to explain the role of tampons in menstrual TSS: (1) Tampons introduce oxygen, which is required for production of TSST-1, into the vagina; (2) tampons bind magnesium, which alters growth kinetics of S. aureus and thus alters the time when TSST-1 is made; and (3) pluronic L-92, a surfactant present in the Rely tampon, which was highly associated with TSS, amplifies production of TSST-1. Certain other surfactants may have similar effects.

Nonmenstrual TSS occurs in both males and females, adults and children, and it is associated with S. aureus strains that make TSST-1 or staphylococcal enterotoxins, notably enterotoxin serotypes B and C. The illness occurs in association with nearly any kind of staphylococcal infection, but major forms have been identified: postsurgical, influenza associated, RED syndrome (see below), and occasionally with use of contraceptive diaphragms.

Type
Chapter
Information
Publisher: Cambridge University Press
Print publication year: 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×