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Ugeskrift For Laeger May 2021Toxic shock syndrome is a potentially deadly toxin-mediated disease in which quick diagnosis is imperative for treatment and prognosis. This is a case report of a...
Toxic shock syndrome is a potentially deadly toxin-mediated disease in which quick diagnosis is imperative for treatment and prognosis. This is a case report of a 21-year-old woman admitted with high fever, confusion, petechial rash and hypotension. During catherisation a tampon was found, and from a vaginal swab Staphylococcus aureus was grown. The patient was hospitalised for eight days, two of which were at the intensive care unit for norepinephrine infusion for hypotension. She was successfully treated with the antibiotics dicloxacillin and clindamycin.
Topics: Adult; Anti-Bacterial Agents; Clindamycin; Female; Humans; Shock, Septic; Staphylococcal Infections; Staphylococcus aureus; Young Adult
PubMed: 33998442
DOI: No ID Found -
The Yale Journal of Biology and Medicine Dec 2011This essay examines factors leading to the identification of Toxic Shock Syndrome with the bacteria Staphylococcus aureus in 1978 and the specific role of Rely tampons... (Review)
Review
This essay examines factors leading to the identification of Toxic Shock Syndrome with the bacteria Staphylococcus aureus in 1978 and the specific role of Rely tampons in generating a technologically rooted health crisis. The concept biologically incompatible technology is offered to explain the relationship between constituent bacteria, women's menstrual cycles, and a reactive technology that converged to create the ideal environment for the S. aureus bacteria to live and flourish in some women. The complicated and reactive relationship of the Rely tampon to emergent disease, corporate interests, public health, and injury law reveals the dangers of naturalizing technologies.
Topics: Biomedical Technology; Decision Making; Female; Humans; Menstrual Hygiene Products; Policy Making; Shock, Septic; Staphylococcus aureus
PubMed: 22180682
DOI: No ID Found -
CMAJ : Canadian Medical Association... May 2017
Topics: Clinical Laboratory Techniques; Consumer Health Information; Consumer Product Safety; Female; Humans; Menstrual Hygiene Products; Shock, Septic; United States
PubMed: 28536130
DOI: 10.1503/cmaj.161479 -
Emerging Infectious Diseases Jan 2017Gene mutations in the virulence regulator CovR/S of group A Streptococcus play a substantial role in the pathogenesis of streptococcal toxic shock syndrome. We screened...
Gene mutations in the virulence regulator CovR/S of group A Streptococcus play a substantial role in the pathogenesis of streptococcal toxic shock syndrome. We screened 25 group B Streptococcus (GBS) isolates obtained from patients with streptococcal toxic shock syndrome and found only 1 GBS clone harboring this kind of mutation.
Topics: Adult; Aged; Aged, 80 and over; Bacterial Proteins; Female; Gene Expression Regulation, Bacterial; Humans; Infant, Newborn; Male; Middle Aged; Multilocus Sequence Typing; Mutation; Repressor Proteins; Serotyping; Shock, Septic; Streptococcal Infections; Streptococcus agalactiae; Survival Analysis; Virulence; Virulence Factors
PubMed: 27983484
DOI: 10.3201/eid2301.161063 -
PloS One 2018The pathogenesis of Kawasaki disease (KD) remains unknown and there is accumulating evidence for the importance of the innate immune system in initiating and mediating...
The pathogenesis of Kawasaki disease (KD) remains unknown and there is accumulating evidence for the importance of the innate immune system in initiating and mediating the host inflammatory response. We compared innate immune responses in KD and toxic shock syndrome (TSS) participants more than two years after their acute illness with control participants to investigate differences in their immune phenotype. Toxic shock syndrome shares many clinical features with KD; by including both disease groups we endeavoured to explore changes in innate immune responses following acute inflammatory illnesses more broadly. We measured the in vitro production of interferon (IFN)-γ, tumour necrosis factor (TNF)-α, interleukin (IL)-1β, IL-6, IL-1 receptor antagonist (IL-1ra), and IL-10 following whole blood stimulation with toll-like receptor and inflammasome ligands in 52 KD, 20 TSS, and 53 control participants in a case-control study. Analyses were adjusted for age, sex, and unstimulated cytokine concentrations. Compared to controls, KD participants have reduced IL-1ra production in response to stimulation with double stranded RNA (geometric mean ratio (GMR) 0.37, 95% CI 0.15, 0.89, p = 0.03) and increased IL-6 production in response to incubation with Lyovec™ (GMR 5.48, 95% CI 1.77, 16.98, p = 0.004). Compared to controls, TSS participants have increased IFN-γ production in response to peptidoglycan (GMR 4.07, 95% CI 1.82, 9.11, p = 0.001), increased IL-1β production to lipopolysaccharide (GMR 1.64, 95% CI 1.13, 2.38, p = 0.01) and peptidoglycan (GMR 1.61, 95% CI 1.11, 2.33, p = 0.01), and increased IL-6 production to peptidoglycan (GMR 1.45, 95% CI 1.10, 1.92, p = 0.01). Years following the acute illness, individuals with previous KD or TSS exhibit a pro-inflammatory innate immune phenotype suggesting a possible underlying immunological susceptibility or innate immune memory.
Topics: Adolescent; Adult; Case-Control Studies; Child; Female; Humans; Immunity, Innate; Inflammasomes; Male; Mucocutaneous Lymph Node Syndrome; Shock, Septic; Toll-Like Receptors; Young Adult
PubMed: 29447181
DOI: 10.1371/journal.pone.0191830 -
Emerging Infectious Diseases 1995Since the 1980s there has been a marked increase in the recognition and reporting of highly invasive group A streptococcal infections with or without necrotizing... (Comparative Study)
Comparative Study Review
Since the 1980s there has been a marked increase in the recognition and reporting of highly invasive group A streptococcal infections with or without necrotizing fasciitis associated with shock and organ failure. Such dramatic cases have been defined as streptococcal toxic-shock syndrome. Strains of group A streptococci isolated from patients with invasive disease have been predominantly M types 1 and 3 that produce pyrogenic exotoxin A or B or both. In this paper, the clinical and demographic features of streptococcal bacteremia, myositis, and necrotizing fasciitis are presented and compared to those of streptococcal toxic-shock syndrome. Current concepts in the pathogenesis of invasive streptococcal infection are also presented, with emphasis on the interaction between group A Streptococcus virulence factors and host defense mechanisms. Finally, new concepts in the treatment of streptococcal toxic-shock syndrome are discussed.
Topics: Animals; Anti-Bacterial Agents; Bacteremia; Clindamycin; Clostridium; Clostridium perfringens; Debridement; Drug Resistance, Microbial; Endotoxins; Exotoxins; Fasciitis, Necrotizing; Humans; Mice; Myositis; Penicillin Resistance; Penicillins; Shock, Septic; Streptococcal Infections; Streptococcus pyogenes; Virulence
PubMed: 8903167
DOI: 10.3201/eid0103.950301 -
Microbiology Spectrum Aug 2023Staphylococcus aureus is a human pathogen with many infections originating on mucosal surfaces. One common group of S. aureus is the USA200 (CC30) clonal group, which...
Staphylococcus aureus is a human pathogen with many infections originating on mucosal surfaces. One common group of S. aureus is the USA200 (CC30) clonal group, which produces toxic shock syndrome toxin-1 (TSST-1). Many USA200 infections occur on mucosal surfaces, particularly in the vagina and gastrointestinal tract. This allows these organisms to cause cases of menstrual TSS and enterocolitis. The current study examined the ability of two lactobacilli, Lactobacillus acidophilus strain LA-14 and Lacticaseibacillus rhamnosus strain HN001, for their ability to inhibit the growth of TSST-1 positive S. aureus, the production of TSST-1, and the ability of TSST-1 to induce pro-inflammatory chemokines from human vaginal epithelial cells (HVECs). In competition growth experiments, L. rhamnosus did not affect the growth of TSS S. aureus but did inhibit the production of TSST-1; this effect was partially due to acidification of the growth medium. L. acidophilus was both bactericidal and prevented the production of TSST-1 by S. aureus. This effect appeared to be partially due to acidification of the growth medium, production of HO, and production of other antibacterial molecules. When both organisms were incubated with S. aureus, the effect of L. acidophilus LA-14 dominated. In experiments with HVECs, neither lactobacillus induced significant production of the chemokine interleukin-8, whereas TSST-1 did induce production of the chemokine. When the lactobacilli were incubated with HVECs in the presence of TSST-1, the lactobacilli reduced chemokine production. These data suggest that these two bacteria in probiotics could reduce the incidence of menstrual and enterocolitis-associated TSS. Toxic shock syndrome (TSS) Staphylococcus aureus commonly colonize mucosal surfaces, giving them the ability to cause TSS through the action of TSS toxin-1 (TSST-1). This study examined the ability of two probiotic lactobacilli to inhibit S. aureus growth and TSST-1 production, and the reduction of pro-inflammatory chemokine production by TSST-1. Lacticaseibacillus rhamnosus strain HN001 inhibited TSST-1 production due to acid production but did not affect S. aureus growth. Lactobacillus acidophilus strain LA-14 was bactericidal against S. aureus, partially due to acid and HO production, and consequently also inhibited TSST-1 production. Neither lactobacillus induced the production of pro-inflammatory chemokines by human vaginal epithelial cells, and both inhibited chemokine production by TSST-1. These data suggest that the two probiotics could reduce the incidence of mucosa-associated TSS, including menstrual TSS and cases originating as enterocolitis.
Topics: Female; Humans; Staphylococcus aureus; Shock, Septic; Lactobacillus; Hydrogen Peroxide; Enterotoxins; Chemokines; Staphylococcal Infections; Probiotics
PubMed: 37404182
DOI: 10.1128/spectrum.01735-23 -
BMJ Case Reports Apr 2015
Topics: Adult; Anti-Bacterial Agents; Bacterial Toxins; Exanthema; Fever; Humans; Male; Shock, Septic; Staphylococcus aureus; Streptococcus pyogenes
PubMed: 25878235
DOI: 10.1136/bcr-2015-209635 -
Clinical Microbiology Reviews Oct 1988In the past 10 years, we have learned much about TSS and S. aureus and its toxins. A number of important biologic principles have been reemphasized in this first decade... (Review)
Review
In the past 10 years, we have learned much about TSS and S. aureus and its toxins. A number of important biologic principles have been reemphasized in this first decade of TSS research: S. aureus is a very complex organism, one not likely to yield quick answers; in vitro observations must always be confirmed in the patient; animal models may not always be reliable replicates of human disease; and epidemiologic associations cannot be equated with causation. Toxic shock is an intricate phenomenon with many interesting scientific facets. Unraveling its mysteries will undoubtedly teach us more about the complex interaction of patients and microorganisms.
Topics: Female; Humans; Shock, Septic
PubMed: 3069202
DOI: 10.1128/CMR.1.4.432 -
International Journal of Molecular... Nov 2023Endotoxin, also referred to as lipopolysaccharide (LPS), is a potent stimulator of the inflammatory cascade which may progress to sepsis and septic shock. The term... (Review)
Review
Endotoxin, also referred to as lipopolysaccharide (LPS), is a potent stimulator of the inflammatory cascade which may progress to sepsis and septic shock. The term endotoxic septic shock has been used for patients who have a clinical phenotype that is characterized by high endotoxin activity in addition to a high burden of organ failure; especially a pattern of organ failure including hepatic dysfunction, acute kidney injury, and various forms of endothelial dysfunction. Endotoxic septic shock has been a target for drug therapy for decades with no success. A likely barrier to their success was the inability to quantify endotoxin in the bloodstream. The Endotoxin Activity Assay (EAA) is positioned to change this landscape. In addition, medical devices using adsorptive technology in an extra-corporeal circulation has been shown to remove large quantities of endotoxin from the bloodstream. Focusing on the use of EAA to determine high concentrations of endotoxin will allow patients with endotoxic septic shock to be identified quickly and these patients may benefit most from removal of endotoxin using extracorporeal methods.
Topics: Humans; Shock, Septic; Sepsis; Endotoxins; Lipopolysaccharides
PubMed: 38003374
DOI: 10.3390/ijms242216185