一种外毒素介导的疾病，多为 A 族链球菌或金黄色葡萄球菌感染引起
首发体征和症状可为非特异性，但呈急性起病，且毒性作用较早发生，导致严重的危及生命的疾病和多器官系统衰竭
早期诊断和治疗很关键
链球菌中毒性休克综合征 (TSS) 可伴随任意部位的感染发生，但更常见的是皮肤感染
葡萄球菌 TSS（经期或非经期）与卫生棉的超期使用、产后感染和其他部位的病原体感染有关
治疗手段包括在重症监护病房 (ICU) 内的支持疗法、早期经验抗生素治疗，进一步的培养物敏感性抗生素治疗。 可能需要外科清创术来治疗深部链球菌感染
中毒性休克综合征（toxic shock syndrome, TSS）是由细菌感染引起的外毒素介导的疾病。常见的病原体包括 A 族链球菌（酿脓链球菌）、[1]Centers for Disease Control and Prevention Working Group on Severe Streptococcal Infections. Defining the group A streptococcal toxic shock syndrome: rationale and consensus definition. JAMA. 1993 Jan 20;269(3):390-1.
http://www.ncbi.nlm.nih.gov/pubmed/8418347?tool=bestpractice.com
[2]Centers for Disease Control and Prevention. Streptococcal toxic shock syndrome (STSS): 2010 case definition. 2010 [internet publication].
http://wwwn.cdc.gov/NNDSS/script/casedef.aspx?CondYrID=858&DatePub=1/1/2010%2012:00:00%20AM
或者甲氧西林敏感（methicillin-sensitive, MSSA）或耐甲氧西林（methicillin-resistant, MRSA）金黄色葡萄球菌。[3]Centers for Disease Control and Prevention. Case definitions for infectious conditions under public health surveillance. MMWR Recomm Rep. 1997 May 2;46(10):1-55.
http://www.cdc.gov/mmwr/preview/mmwrhtml/00047449.htm
http://www.ncbi.nlm.nih.gov/pubmed/9148133?tool=bestpractice.com
虽然首发体征和症状可为非特异性（如发热、寒战、肌痛、头痛），但其病程进展迅速，且休克和多器官系统衰竭可能在病程早期就会发生。
葡萄球菌 TSS 可以分为 2 组：经期 TSS，发生于经期单片卫生棉或是高吸收性卫生棉的超期使用；非经期 TSS，由产后阴道和剖腹产伤口感染多种葡萄球菌引起。[4]Reingold AL, Hargrett NT, Shands KN, et al. Toxic shock syndrome surveillance in the United States, 1980 to 1981. Ann Intern Med. 1982 Jun;96(6 Pt 2):875-80.
http://www.ncbi.nlm.nih.gov/pubmed/7091960?tool=bestpractice.com
[5]Kotler DP, Sandkovsky U, Schlievert PM, et al. Toxic shock-like syndrome associated with staphylococcal enterocolitis in an HIV-infected man. Clin Infect Dis. 2007 Jun 15;44(12):e121-3.
http://cid.oxfordjournals.org/content/44/12/e121.long
http://www.ncbi.nlm.nih.gov/pubmed/17516392?tool=bestpractice.com
[6]Paterson MP, Hoffman EB, Roux P. Severe disseminated staphylococcal disease associated with osteitis and septic arthritis. J Bone Joint Surg Br. 1990 Jan;72(1):94-7.
http://www.bjj.boneandjoint.org.uk/content/72-B/1/94.long
http://www.ncbi.nlm.nih.gov/pubmed/2298804?tool=bestpractice.com
[7]Ferguson MA, Todd JK. Toxic shock syndrome associated with Staphylococcus aureus sinusitis in children. J Infect Dis. 1990 May;161(5):953-5.
http://www.ncbi.nlm.nih.gov/pubmed/2324544?tool=bestpractice.com
[8]Parsonnet J. Nonmenstrual toxic shock syndrome: new insights into diagnosis, pathogenesis, and treatment. Curr Clin Top Infect Dis. 1996;16:1-20.
http://www.ncbi.nlm.nih.gov/pubmed/8714246?tool=bestpractice.com
