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Toxic Shock Syndrome: Multimedia
Updated: May 1, 2009
Multimedia
 | Media file 1: Description of M proteins and streptococcal toxins. |
 | Media file 2: Group A streptococci cause beta hemolysis on blood agar. |
 | Media file 3: Group A streptococci on Gram stain of blood isolated from a patient who developed toxic shock syndrome. Courtesy of T. Matthews. |
 | Media file 4: This schematic shows interaction among T-cell receptor, superantigen, and class II major histocompatability complex. The binding of superantigen to class II molecules and T-cell receptors is not limited by antigen specificity and lies outside the normal antigen binding sites. |
 | Media file 5: Progression of soft tissue swelling to vesicle or bullous formation is an ominous sign and suggests streptococcal shock syndrome. Courtesy of S. Manocha. |
 | Media file 6: A 46-year-old man presented with nonnecrotizing cellulitis and streptococcal toxic shock syndrome. The leg was incised to exclude underlying necrotizing infection. Courtesy of Rob Green, MD. |
 | Media file 7: A 46-year-old man presented with nonnecrotizing cellulitis and streptococcal toxic shock syndrome. This patient also had streptococcal pharyngitis. Courtesy of Rob Green, MD. |
 | Media file 8: A 46-year-old man presented with nonnecrotizing cellulitis and streptococcal toxic shock syndrome. The patient had diffuse erythroderma, a characteristic feature of the syndrome. Courtesy of Rob Green, MD. |
 | Media file 9: A 46-year-old man presented with nonnecrotizing cellulitis and streptococcal toxic shock syndrome. The patient had diffuse erythroderma, a characteristic feature of the syndrome. The patient improved with antibiotics and intravenous gammaglobulin therapy. Several days later, a characteristic desquamation of the skin occurred over palms and soles. Courtesy of Rob Green, MD. |
 | Media file 10: A 58-year-old patient presented in septic shock. On physical examination, progressive swelling of the right groin was observed. On exploration, necrotizing cellulitis, but not fasciitis, was present. The cultures grew group A streptococci. The patient developed severe shock (toxic shock syndrome). The CT scanning helped evaluate the extent of infection and exclude other pathologies, such as psoas abscess, osteomyelitis, and inguinal hernia. |
 | Media file 11: A 58-year-old patient presented in septic shock. On physical examination, progressive swelling of the right groin was observed. On exploration, necrotizing cellulitis, but not fasciitis, was present. The cultures grew group A streptococci. The patient developed severe shock (toxic shock syndrome). The CT scanning helped evaluate the extent of infection and exclude other pathologies, such as psoas abscess, osteomyelitis, and inguinal hernia. |
 | Media file 12: A 58-year-old patient presented in septic shock. On physical examination, progressive swelling of the right groin was observed. On exploration, necrotizing cellulitis, but not fasciitis, was present. The cultures grew group A streptococci. The patient developed severe shock (toxic shock syndrome). The CT scanning helped evaluate the extent of infection and exclude other pathologies, such as psoas abscess, osteomyelitis, and inguinal hernia. |
 | Media file 13: Necrotizing cellulitis of toxic shock syndrome. |
 | Media file 14: Soft tissue infection secondary to group A streptococci, leading to toxic shock syndrome. |
 | Media file 15: Extensive debridement of necrotizing fasciitis of the hand. |
 | Media file 16: The hand is healing following aggressive surgical debridement of necrotizing fasciitis of the hand (see Image 15). |
 | Media file 17: Necrosis of the little toe of the right foot and cellulitis of the foot secondary to group A streptococci. |
More on Toxic Shock Syndrome |
| Overview: Toxic Shock Syndrome |
| Differential Diagnoses & Workup: Toxic Shock Syndrome |
| Treatment & Medication: Toxic Shock Syndrome |
| Follow-up: Toxic Shock Syndrome |
 Multimedia: Toxic Shock Syndrome |
| References |
| Further Reading |
| « Previous Page |
References
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Further Reading
Clinical guidelines
Female barrier methods.
Faculty of Sexual and Reproductive Healthcare - Professional Association. 2007 Jun. 17 pages. NGC:006305
Practice guidelines for the diagnosis and management of skin and soft-tissue infections.
Infectious Diseases Society of America - Medical Specialty Society. 2005 Nov 15. 34 pages. NGC:004581
Clinical trials
Long Term Follow-up of Patients With Group A Streptococcal Infection Originating From the Genital Tract
Early-Onset Sepsis Surveillance Study
Related eMedicine topics
Staphylococcus Aureus Infection
Streptococcal Infection, Group A
Staphylococcal Infections
Toxic Shock Syndrome (Dermatoloy)
Toxic Shock Syndrome (Emergency Medicine)
Toxic Shock Syndrome (Pediatrics)
Keywords
toxic shock syndrome, TSS, flesh-eating disease, toxic shock, septic shock, Staphylococcus aureus, S aureus, group A Streptococcus, GAS, Streptococcus pyogenes, S pyogenes
