Toxic shock syndrome (TSS) is an acute-onset, multisystem illness characterized by fever (>102°F), hypotension (systolic pressure, <90 mm of Hg), sunburn-like rash, peeling of the skin, and a variable multiorgan component that often initially appears flu-like, perhaps including vomiting and diarrhea. The illness is caused by Staphylococcus aureus bacteria that make superantigens (SAgs), usually TSS toxin-1 (TSST-1), enterotoxin B (SEB), or SEC; these toxins exert systemic effects on the host. Probable TSS has been described as the same illness but lacking one of the defining criteria of TSS. Parsonnet suggests that the term toxin-mediated disease be used for cases of apparent TSS in which more than one clinical feature is absent though it can be established that S. aureus is present and that the patient lacks protective antibodies.
