Toxic Shock Syndrome
Also written as TSS.
Toxic shock syndrome — caused by TSST-1 (a superantigen); classic scenario: nasal tampon left in place post-surgery, fever, hypotension, diffuse erythematous rash including palms/soles, elevated liver enzymes, renal failure
What our notes say
- Toxic shock syndrome — caused by TSST-1 (a superantigen); classic scenario: nasal tampon left in place post-surgery, fever, hypotension, diffuse erythematous rash including palms/soles, elevated liver enzymes, renal failure (Streptococcus Classification, S. pyogenes, Rheumatic Fever, AGN)
- TOXIC SHOCK SYNDROME vs SCALDED SKIN SYNDROME (5-mark comparison, both caused by *S. aureus* toxins) (Streptococcus Classification, S. pyogenes, Rheumatic Fever, AGN)
- *Explanation:* Toxic shock syndrome is caused by superantigen toxins (such as TSST-1 and enterotoxins) that bypass normal antigen processing and cause massive, non-specific T-cell activation, leading to cytokine storm and systemic shock. (Mbmm3311 – Medical Bacteriology)
- *Explanation:* Staphylococcus aureus is the primary cause of toxic shock syndrome, particularly associated with tampon use (menstrual TSS) or wound infections (non-menstrual TSS). (Mbmm3311 – Medical Bacteriology)
- D) Toxic shock syndrome toxin-1 is produced by hemolytic strains of *Staphylococcus epidermidis* (Medical Bacteriology and Entomology MCQs)
- Toxic shock syndrome follows staphylococcal or streptococcal toxin production at a wound, tampon, abscess or surgical site. (Year 6 Gynaecology CAT 1 (MBOG 6511): 13 December 2019, 4 short answers and 16 M)
Study material on Toxic Shock Syndrome
- Medical Bacteriology And Parasitology End Year 2024/2025
- Streptococcus Classification, S. pyogenes, Rheumatic Fever, AGN
- Mbmm3311 – Medical Bacteriology
- Medical Bacteriology and Entomology MCQs
- Year 6 Gynaecology CAT 1 (MBOG 6511): 13 December 2019, 4 short answers and 16 MCQs
- Medical Bacteriology and Entomology
- Medical Bacteriology Examination MCQs
- Pharmco Notes
- Weekly Year 2: Microbiology Exam - June 12, 2026 (Section A: MCQs)
- Medical Bacteriology
Practice questions on Toxic Shock Syndrome
The characteristic feature of Toxic Shock Syndrome occurring 1-2 weeks after acute illness is
- High fever
- Hypotension
- Desquamation of palms and soles
- Erythematous rash
- Mostly unchanged in early disease
Answer: B. While fever, hypotension, and rash occur during the acute phase, the pathognomonic (characteristic) late sign is desquamation (skin peeling) of palms and soles occurring 1-2 weeks later. ---
Toxic Shock Syndrome Toxin-1 (TSST-1) causes disease by
- Direct cytotoxic effects
- TSST-1
- Blocking protein synthesis
- Disrupting cell membranes
- Mostly unchanged in early disease
Answer: B. TSST-1 is a superantigen that causes massive, non-specific T-cell activation and cytokine release (IL-1, IL-2, TNF), leading to the systemic inflammatory response seen in toxic shock syndrome. ---
The characteristic feature of Toxic Shock Syndrome (TSS) occurring 1-2 weeks after acute illness is not typical. TSS usually has a rapid onset and is characterized by fever, rash, hypotension, and multisystem involvement, often associated with menstrual hygiene products or surgical wound infections.
- A) Rapid onset of fever, rash, hypotension, and multisystem involvement
- B) Chronic fatigue and joint pain
- C) Slow progression of skin lesions
- D) Absence of fever and rash
Answer: A. Toxic Shock Syndrome (TSS) is an acute, life-threatening illness. Its hallmark is a sudden onset of high fever, a diffuse erythematous rash, hypotension, and evidence of multisystem organ involvement (e.g., kidney, liver, blood). The 1-2 week delay mentioned in the question is not characteristic of the typical presentation of TSS.
The characteristic feature of Toxic Shock Syndrome occurring 1-2 weeks after acute illness is:
- Generalized rash and desquamation
- Severe diarrhea
- Pharyngeal exudates
- Muscle weakness
Answer: A. While TSST-1 can cause various symptoms, a characteristic feature of toxic shock syndrome, especially in its recovery phase or severe cases, is a diffuse erythematous rash followed by desquamation (peeling) of the skin, particularly on the palms and soles.
In Toxic Shock Syndrome, what characteristic skin feature typically occurs 1-2 weeks after the acute illness?
- Petechiae
- Desquamation (peeling)
- Pustules
- Necrosis
Answer: B. Desquamation, particularly of the palms and soles, is a late-stage finding of TSS.
The characteristic skin feature of Toxic Shock Syndrome occurring 1-2 weeks after acute illness is:
- Maculopapular rash
- Desquamation (peeling) of palms and soles
- Vesicular eruption
- Eschar formation
Answer: B. Desquamation of the skin, particularly on the hands and feet, is a late sign of TSS.