"bacterial pneumonia post-influenza"
"desquamation occurs 1–2 weeks after symptoms first appear"
"Toxic shock syndrome (TSS) is a severe bacterial toxin-mediated condition, characterised by an initial soft tissue infection that rapidly progresses to systemic disease and circulatory collapse 5. It is due to a Gram-positive infection, most frequently Staphylococcus aureus or Streptococcus pyogenes 1,2."
"All cases of toxic shock syndrome are produced by Gram-positive bacteria, the most commonly implicated being Staphylococcus aureus or Streptococcus pyogenes (group A streptococci)."
"However, similar presentations have been seen in those with group B (S. agalactiae), C (S. equis), and G (S. dysgalactiae) streptococcal infections. Rarely, Clostridium species-related toxic shock syndrome has been reported (e.g. C. perfringens, C. sordellii) 1,3-5."
"Unfortunately, in early disease, the radiological findings may create a false sense of security due to their apparently benign appearance. Soft tissue inflammation may initially be mild, no abscesses might be evident, and no gas may be seen. In fact, S. pyogenes is not a gas-forming organism. Indeed, in the early phase of fasciitis, there may be a clear lack of concordance between the imaging and surgical presentation in some cases 5."
"Mortality rates vary widely, 5-22% for staphylococcal toxic shock syndrome, and from 30-70% for streptococcal toxic shock syndrome 1,2."
"Commonly"
"Less commonly"
"staphylococci: toxic shock syndrome toxin-1 (TSST-1), enterotoxins B and C"
"The toxic shock syndrome toxin-1 (TSST-1) also has deleterious effects on the vasculature, with marked capillary leakiness, fluid shifts and hypotension."
"Most cases of menstruation-related toxic shock syndrome are secondary to the release of TSST-1. For non-menstrual-related presentations, the toxic shock syndrome toxin is implicated in only half the cases, with enterotoxins responsible for the other 50% 2."
"Rocky Mountain spotted fever"
Expected headings
"Staphylococcal toxic shock syndrome"
"Streptococcal toxic shock syndrome"
"Skin manifestations"
"Pathogenesis"
"Staphylococcal toxic shock syndrome is the most common form, with an annual incidence of 0.5 cases per 100,000 population, with a slightly lower incidence of the second commonest form, streptococcal toxic shock syndrome, estimated at 0.4/100,000 1."
"However, similar presentations have been seen in those with group B (S. agalactiae), C (S. equis), and G (S. dysgalactiae) streptococcal infections. Rarely, Clostridium species-related toxic shock syndrome has been reported (e.g. C. perfringens, C. sordellii) 1,3-5."
"Superantigens bypass normal immune system mechanisms of antigen presentation and hyperstimulate clonal T cells by cross-linking major histocompatibility complex (MHC) class II molecules on antigen-presenting cells to T-cell receptors (TCRs) 2. Consequently, a massive release of cytokines, including gamma interferon, interleukins and tumour necrosis factors, creates a so-called cytokine storm."