Article Sections

Introduction

Staphylococcal toxic shock syndrome (TSS) is a life-threatening condition caused by exotoxins produced by Staphylococcus aureus within a retained foreign body or a wound infection.  It is characterized by sudden onset of high fever, rash, hypotension, and multiorgan dysfunction.

Risk factors

Risk factors for the development of staphylococcal TSS include the following:

  • Retained foreign body (eg, tampon, nasal/vaginal packing); prolonged, single use increases risk
  • Surgical/postpartum wound infection
  • Skin and soft tissue infections (eg, mastitis, burns)

Wounds may not appear infected due to a poor local inflammatory response.

Pathophysiology

Staphylococcal TSS is an exotoxin-mediated disease.  Most cases are linked to prolonged tampon use, nasal wound packing, or wound infections, each of which provide a medium for localized S aureus proliferation and the elaboration of pyrogenic toxin superantigens (eg, TSS toxin-1) into the bloodstream.

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