Toxic shock syndrome (TSS) is an acute life-threatening illness, usually caused by infection with either Staphylococcus aureus orStreptococcus pyogenes. The symptoms of TSS are a high fever, vomiting, diarrhea, a sunburn-like rash, red eyes, dizziness, lightheadedness, muscle aches and low blood pressure. In a severe case, TSS can cause kidney and liver failure – any of these symptoms requires immediate medical care. The annual incidence of staphylococcal TSS in the United States is 1-5 cases per 100,000 menstruating women. The annual incidence of streptococcal TSS is 5-10 cases per 100,000 individuals. Staphylococcal TSS is more common in females during menstruation.
Patients with TSS must be treated immediately. In case of unconfirmed suspected TSS broad spectrum antibiotics like clindamycin+carbapenem/beta-lactamase inhibitor/vancomycin must be administered. Aggressive fluid management, ventilation, renal replacement therapy and inotropic support are essential as supportive care. The FDA recently approved 3 new antibiotics, oritavancin, dalbavancin, and tedizolid, for the treatment of acute bacterial skin infections. These agents are active against S. aureus, S. pyogenes, S. agalactiae, and S. anginosus group.