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Toxic shock syndrome (TSS) is a potentially fatal illness caused by a bacterial toxin. Different bacterial toxins may cause toxic shock syndrome, depending on the situation. The causative bacteria include ''Staphylococcus aureus'', where TSS is caused by enterotoxin type B or TSST-1, and ''Streptococcus pyogenes'', where it is caused by streptococcal pyrogenic exotoxins. Streptococcal TSS is sometimes referred to as toxic shock-like syndrome (TSLS) or streptococcal toxic shock syndrome (STSS). == Signs and symptoms == Symptoms of toxic shock syndrome vary depending on the underlying cause. TSS resulting from infection with the bacterium ''Staphylococcus aureus'' typically manifests in otherwise healthy individuals with high fever, accompanied by low blood pressure, malaise and confusion, which can rapidly progress to stupor, coma, and multiple organ failure. The characteristic rash, often seen early in the course of illness, resembles a sunburn, and can involve any region of the body, including the lips, mouth, eyes, palms and soles. In patients who survive the initial phase of the infection, the rash ''desquamates'', or peels off, after 10–14 days. In contrast, TSS caused by the bacterium ''Streptococcus pyogenes'', or TSLS, typically presents in people with pre-existing skin infections with the bacteria. These individuals often experience severe pain at the site of the skin infection, followed by rapid progression of symptoms as described above for TSS. In contrast to TSS caused by ''Staphylococcus'', streptococcal TSS less often involves a sunburn-like rash. For staphylococcal toxic shock syndrome, the diagnosis is based strictly upon CDC criteria defined in 2011, as follows: # Body temperature > 38.9 °C (102.02 °F) # Systolic blood pressure < 90 mmHg # Diffuse macular erythroderma # Desquamation (especially of the palms and soles) 1–2 weeks after onset. # Involvement of three or more organ systems: # * Gastrointestinal (vomiting, diarrhea) # * Muscular: severe myalgia or creatine phosphokinase level at least twice the upper limit of normal for laboratory # * Mucous membrane hyperemia (vaginal, oral, conjunctival) # * Kidney failure (serum creatinine > 2 times normal) # * Liver inflammation (bilirubin, AST, or ALT > 2 times normal) # * Low platelet count (platelet count < 100,000 / mm³) # * Central nervous system involvement (confusion without any focal neurological findings) # Negative results of: # * blood, throat, and CSF cultures for other bacteria (besides ''S. aureus'') # * negative serology for Rickettsia infection, leptospirosis, and measles. Cases are classified as confirmed or probable based on the following: * Confirmed: All six of the criteria above are met (unless the patient dies before desquamation can occur) * Probable: Five of the six criteria above are met. 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「Toxic shock syndrome」の詳細全文を読む スポンサード リンク
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