Toxic Shock Syndrome (TSS)

  • Medical Author:
    Charles Patrick Davis, MD, PhD

    Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

  • Medical Editor: Melissa Conrad Stöppler, MD
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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What causes toxic shock syndrome?

The cause of toxic shock syndrome (TSS) is one of several closely related exotoxins secreted by bacteria that are infecting the person. The toxins activate T cells of the immune system to produce chemicals known as cytokines that subsequently cause shock and tissue damage. Although there are several closely related exotoxins, about 80% of individuals with TSS have an illness caused by TSST-1 or a similar exotoxin. Other exotoxins such as those produced by enterococci A, C, D, E, and H cause most of the remaining 20% of infections.

M protein, a filamentous protein on the cell membrane of group A Streptococcus bacteria enhances the likelihood of the bacterial strain being more likely to cause disease. Bacterial strains that lack M protein are less lethal because M protein can protect bacteria from host immune defenses. In addition, M protein apparently enhances cell damage and inflammation caused by exotoxins.

What are risk factors for toxic shock syndrome?

Risk factors for TSS include a history of using superabsorbent tampons, surgical wounds, history of using a diaphragm or contraceptive sponge, having a localized infection deep in the skin, abortion, burns, and immunosuppression (for example, as seen with diabetes, chronic lung or heart disease, or in elderly patients).

Medically Reviewed by a Doctor on 3/16/2016

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