Toxic shock syndrome: major advances in pathogenesis, but not

Critical care clinics · Jul 2013

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Toxic shock syndrome: major advances in pathogenesis, but not treatment.

Toxic shock syndrome (TSS) is primarily the result of a superantigen-mediated cytokine storm and M protein-mediated neutrophil activation, resulting in the release of mediators leading to respiratory failure, vascular leakage, and shock. Mortality for streptococcal TSS still hovers at 50%. There is evidence to support a role for intravenous immunoglobulin (IVIG) in the treatment of streptococcal TSS. An observational study suggests that an initial conservative surgical approach combined with the use of immune modulators, such as IVIG, may reduce the morbidity associated with extensive surgical exploration in hemodynamically unstable patients without increasing mortality.

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- Donald E Low.
- Department of Microbiology, Mount Sinai Hospital, University Health Network, University of Toronto, 600 University Avenue, Room 1487, Toronto, Ontario M5G 1X5, Canada. delow@mtsinai.on.ca
- Crit Care Clin. 2013 Jul 1; 29 (3): 651-75.
AbstractToxic shock syndrome (TSS) is primarily the result of a superantigen-mediated cytokine storm and M protein-mediated neutrophil activation, resulting in the release of mediators leading to respiratory failure, vascular leakage, and shock. Mortality for streptococcal TSS still hovers at 50%. There is evidence to support a role for intravenous immunoglobulin (IVIG) in the treatment of streptococcal TSS. An observational study suggests that an initial conservative surgical approach combined with the use of immune modulators, such as IVIG, may reduce the morbidity associated with extensive surgical exploration in hemodynamically unstable patients without increasing mortality. Copyright © 2013 Elsevier Inc. All rights reserved.

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Toxic shock syndrome: major advances in pathogenesis, but not treatment.

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