Toxic Shock Syndrome

  • Elicia Skelton
  • Anand Swaminathan


Toxic shock syndrome (TSS) is a toxin-mediated systemic inflammatory response syndrome that is classically triggered by either Staphylococcus aureus or Group A Streptococcus. Diagnostic criteria for TSS vary depending on the causal bacteria though symptoms typically involve hypotension in addition to multiorgan involvement. Making the diagnosis of TSS can be challenging as symptoms tend to be nonspecific and multisystemic. Characteristic skin findings of macular erythroderma and desquamation may be present later in the illness course or may not be present at all.

Early recognition is paramount as TSS is associated with high mortality rates if left untreated. Treatment involves supportive care including aggressive fluid resuscitation and maintenance of adequate mean arterial pressures and the use of broad-spectrum antibiotics. The use of IVIG has not been validated, but studies suggest benefits in morbidity and mortality.


Toxic shock syndrome Staphylococcus aureus Group A Streptococcus Exotoxin Macular erythroderma Desquamation 


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Elicia Skelton
    • 1
  • Anand Swaminathan
    • 2
  1. 1.Emergency MedicineBellevue/NYU Emergency DepartmentNew YorkUSA
  2. 2.Emergency MedicineSt. Joseph’s Regional Medical CenterPattersonUSA

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