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Current Infectious Disease Reports

, Volume 12, Issue 5, pp 392–400 | Cite as

Staphylococcal Toxic Shock Syndrome: Mechanisms and Management

  • Jonathan A. Silversides
  • Emma Lappin
  • Andrew J. Ferguson
Article

Abstract

Staphylococcal toxic shock syndrome is a rare complication of Staphylococcus aureus infection in which bacterial toxins act as superantigens, activating very large numbers of T cells and generating an overwhelming immune-mediated cytokine avalanche that manifests clinically as fever, rash, shock, and rapidly progressive multiple organ failure, often in young, previously healthy patients. The syndrome can occur with any site of S. aureus infection, and so clinicians of all medical specialties should have a firm grasp of the presentation and management. In this article, we review the literature on the pathophysiology, clinical features, and treatment of this serious condition with emphasis on recent insights into pathophysiology and on information of relevance to the practicing clinician.

Keywords

Staphylococcus aureus Superantigen Toxic shock syndrome Septic shock Infection Gram-positive Immunoglobulin Clindamycin Linezolid Daptomycin Tigecycline Toll-like receptor T-cell receptor Cytokine Systemic inflammatory response syndrome Early goal-directed therapy Nuclear factor-κB Tumor necrosis factor-α Interleukin-10 Immunomodulation Toxic shock syndrome toxin-1 Methicillin-resistant Staphylococcus aureus (MRSA) Pathogen-associated molecular patterns (PAMP) Polymorphism 

Notes

Disclosure

No potential conflict of interest relevant to this article was reported.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Jonathan A. Silversides
    • 1
  • Emma Lappin
    • 2
  • Andrew J. Ferguson
    • 3
  1. 1.Specialty Registrar in Anaesthesia and Intensive Care Medicine, Regional Intensive Care UnitRoyal Victoria HospitalBelfastUK
  2. 2.Specialist Registrar in AnaesthesiaBelfast City HospitalBelfastUK
  3. 3.Consultant in Intensive Care Medicine and AnaesthesiaCraigavon Area HospitalPortadownUK

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