![]() Use of non-steroidal anti-inflammatory drugs (NSAIDs) may also increase risk, although evidence for this is limited. Skin injury or breakdown: Recently having surgery, a viral infection that causes open sores (like varicella), or other skin injury increases risk for developing STSS.Ĭhronic illnesses: Having alcohol use disorder or diabetes can also increase risk for developing STSS.Īdditionally, strains of group A strep that produce certain virulence factors and exotoxins, particularly streptococcal pyrogenic exotoxins, are more likely to cause STSS and other severe infections. STSS can occur in anyone, but risk factors can include:Īge: STSS is more common in adults 65 years of age or older. Once initial symptoms occur, hypotension generally develops within 24 to 48 hours. The incubation period for STSS varies depending on site of entry. Secondary cases among close contacts or healthcare workers are rare, although have been known to occur. Unfortunately, route of entry remains unknown for up to 50% of cases. The main sites of entry for streptococci leading to toxic shock syndrome include:Īny skin injury or breakdown, including surgical wounds, may provide a site of entry for the bacteria. The bacteria then spread to deep tissues and eventually to the bloodstream. Disease occurs with entry of the bacterium through a compromised barrier (such as a skin injury) or through mucus membranes. These symptoms often quickly progress to sepsis with hypotension, tachycardia, tachypnea, and signs and symptoms suggestive of specific organ failure, including of the following organ systems:Īny group A strep infection may progress to STSS.
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