Toxic Shock Syndrome: Recent Developments in Pathogenesis

    March 1990 in “ The Journal of Pediatrics ”
    Steven D. Resnick
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    TLDR Toxic shock syndrome is caused by a complex interaction of bacterial toxins and the immune system, and understanding this can help improve diagnosis and treatment.
    The 1990 article by Steven D. Resnick, MD, discussed the pathogenesis of toxic shock syndrome (TSS), a condition primarily associated with Staphylococcus aureus and the production of toxic shock syndrome toxin-1 (TSST-1). However, it was noted that TSS could also occur without TSST-1, sometimes with a higher fatality rate. The article reported that nonmenstrual TSS, which makes up about 11% of cases, could be linked to the use of contraceptive sponges and diaphragms. The pathogenesis of TSS was described as a complex interaction between bacterial toxins, the host's immune response, and cytokines like IL-1 and TNF. Symptoms of TSS include high fever, systemic symptoms, a scarlatiniform rash, desquamation, and possible hair and nail loss. The article underscored the need for a better understanding of TSS's multifactorial nature to improve diagnosis and treatment.
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