Toxic Shock Syndrome - Evolution Of An Emerging Disease

Toxic shock syndrome (TSS) was originally described in 1978 in seven patients: four females and three males who presented acutely with fever, hypotension, mucous membrane hyperemia, a scarlatiniform rash (that ultimately desquamated), and multiple organ system failure [1]. A unique Staphylococcus aureus strain, which produced a new epidermal toxin, was isolated from five of the children. By January 1980, 35 cases had been observed, of which 25 were in females with an average age of 28.2 years; only 10 were in males with an average age of 11.6 years [2]. Seven of 10 males had an identifiable focus of S. aureus infection, whereas 20 of 22 females had a watery vaginal discharge from which S. aureus was isolated. Shortly thereafter, cases of TSS were further associated with menstruation and the use of tampons.