Streptococcal toxic shock syndrome

In soft tissue infection caused by group A Streptococcus, streptococcal toxic shock syndrome may occur. Although penicillin and cefazolin are efficacious, experimental models of group A streptococcal infection show clindamycin to be more effective than penicillin. ... 

Since the 1980s, there has been an alarming increase in GAS-mediated invasive disease, not only in frequency, but also in severity. The severest form of invasive infection results in clinical symptoms similar to staphylococcal toxic shock syndrome and was therefore described as streptococcal toxic shock syndrome (STSS). Characteristic symptoms of STSS include hypotension, fever, rash, vomiting, diarrhea, multiple organ failure, and shock [7]. 

Stevens DL Streptococcal toxic shock syndrome associated with necrotizing fasciitis. Annu Rev Med 2000 51 271-288. 

Working Group on Severe Streptococcal Infections Defining the group A streptococcal toxic shock syndrome. Rationale and consensus definition. JAMA 1993 269 390-391. 

Sriskandan S, Moyes D, Cohen J Detection of circulating bacterial superantigen and lymphotoxin-a in patients with streptococcal toxic shock syndrome. Lancet 1996 348 1315-1316. 

Proft T, Sriskandan S, Yang L, Fraser JD Superantigens and streptococcal toxic shock syndrome. Emerg Infect Dis 2003 9 1211-1218. 

Eriksson BKG, Andersson J, Holm SE, Norgren M Invasive group A streptococcal infections T1M1 isolates expressing pyrogenic exotoxins A and B in combination with selective lack of toxin-neutralizing antibodies are associated with increased risk of streptococcal toxic shock syndrome. J Infect Dis 1999 1X0 410 -IIS. 

Yang L, Thomas M, Woodhouse A, Martin D, Fraser J, Proft T Involvement of streptococcal mitogenic exotoxin Z in streptococcal toxic shock syndrome. J Clin Microbiol 2005 43 3570-3573. 

Watanabe-Ohnishi R, Low DE, McGeer A, Stevens DL, Schlievert PM, Newton D, Schwartz B, Kreiswirth B, Kotb M Selective depletion of V beta-bearing T cells in patients with severe invasive group A streptococcal infections and streptococcal toxic shock syndrome. Ontario Streptococcal Study Project. J Infect Dis 1995 171 74-84. 

Infectious disease A 48 year-old female presented with streptococcal toxic shock syndrome Streptococcus pyogenes) and was found to have ingested levamisole-adulterated cocaine [53 ]. 

Freyer CW, Peters M. Palpable purpura complicated by streptococcal toxic shock syndrome resulting inBmb necrosis and amputation a case of levamisole and cocaine coingestion. Pharmacotherapy 2012 32(2) el7-23. 

E, toxic shock syndrome toxin (TSST-1), the streptococcal pyrogenic exotoxins (SPE) A, B, Cs, G, and H, the streptococcal mitogenic exotoxins, SMEZ and SMEZ-2 are the best structurally studied superantigens thus far (Tables 5 and 6). 

Arthritis Death due to streptococcal toxic shock-like syndrome Right shoulder Probable (58)... 

Onizuka T, Oishi K, Ikeda T, Watanabe K, Senba M, Suga K, Nagatake T. [A fatal case of streptococcal toxic shock-like syndrome probably caused by acupuncture.] Kansenshogaku Zasshi 1998 72(7) 776-80. 

Fast DJ, Schlievert PM, Nelson RD Toxic shock syndrome-associated staphylococcal and streptococcal pyrogenic toxins are potent inducers of tumor necrosis factor production. Infect Immun 1989 57 291-294. 

Kreiswirth B, Handley J, Schlievert P, Novick R Cloning and expression of streptococcal pyrogenic exotoxin A and staphylococcal toxic shock syndrome toxin-1 in Bacillus subtilis. Mol Gen Genet 1987 208 84-87. 

Reichardt W, Muller-Alouf H, Alouf J, Kohler W Erythrogenic toxins A, B, and C occurrence of the genes and exotoxin formation from clinical Streptococcus pyogenes strains associated with streptococcal toxic shock-like syndrome. FEMS Microbiol Lett 1992 79 313-322. 

McCormick JK, Tripp TJ, Olmsted SB, Matsuka YY Gahr PJ, Ohlendorf DH, Schlievert PM Development of streptococcal pyrogenic exotoxin C vaccine toxoids that are protective in the rabbit model of toxic shock syndrome. J Immunol 2000 165 2306-2312. 

Staphylococcal enterotoxin B (SEB) is one of seven enterotoxins produced by strains of Staphylococcus aureus. SEB, the best understood of the staphylococcal enterotoxins, can be regarded as the type enterotoxin. Staphylococcal enterotoxins, toxic shock syndrome toxin-1 (TSST-1), and certain other bacterial products (such as streptococcal pyrogenic exotoxins [SPE]) and viral products (which are not discussed in this chapter) are commonly referred to as superantigens because of their profound effects on the immune system. Minute concentrations of superantigens can activate the immune system receptors because they bind with strong avidity to T-cell antigen receptors and class II molecules of the major histocompatibility complex (MHC). 

Betley MJ, Borst DW, Regassa LB. Staphylococcal enterotoxins, toxic shock syndrome toxin and streptococcal pyrogenic exotoxins A comparative study of their molecular biology. Chem Immunol. 1992 55 1-35. 

Musser, J. M. and Krause, R. M. (1998). The revival of group A streptococcal diseases, with a commentary on staphylococcal toxic shock syndrome, p. 185-218. In R.M. Krause (ed.), Emerging Infections. Academic Press, San Diego, CA. 

Bohach, G.A., Fast, D.J., Nelson, R.D., and Schlievert, P.M. 1990. Staphylococcal and streptococcal pyrogenic toxins involved in toxic shock syndrome and related illnesses. Crit. Rev. Microbiol. 17 251-272. 

Hoge, C.W., Schwartz B., Talkington D.F., Brieman, R.F., MacNeill, E.M., and Eglender, S.J. 1993. The changing epidemiology of invasive group A streptococcal infections and the emergence of streptococcal toxic shock-like syndrome. JAMA 269 384-389. 

Schlievert, P.M., Gocke, J.E. and Deringer, J.R. 1993. Group B streptococcal toxic shock-like syndrome Report of a case and purification of an associated pyrogenic toxin. Clin. Infect. Dis. 17 26-31. 

YuCE, Ferretti JJ Molecular epidemiologic analysis of the type A streptococcal exotoxin (erythrogenic toxin) gene (speA) in clinical Streptococcus pyogenes strains. Infect Immun 1989 57 3715-3719. Hauser A, Stevens D, Kaplan E, Schlievert P Molecular analysis of pyrogenic exotoxins from Streptococcus pyogenes isolates associated with toxic shock-like syndrome. J Clin Microbiol 1991 29 1562-1567. 

Stevens, D.L., Tanner, M.H., Winship, J., Swarts, R., Ries, K.M., Schlievert, RM., and Kaplan, E. 1989. Reappearance of scarlet fever toxin A among streptococci in the Rocky Mountain West Association with severe streptococcal soft tissue infection, sepsis and the toxic shock-like syndrome. N. Engl. J. Med. 321 1-7. 

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