Streptococcal Toxic Shock Syndrome (STSS)- Rapidly progressive multiorgan illness, high mortality (30–60%), caused by GAS
- Superantigen mediated: SPE-A → stimulates T cells with massive cytokine release → subsequent shock
- Presents typically with sudden onset pain in an infected soft tissue, flu-like symptoms, CNS symptoms (confusion, coma) → multiorgan failure
- Generalized exanthem less common in STSS (vs. TSS), and STSS more likely in an otherwise healthy adult
- Treatment: intensive supportive therapy, IV penicillinase-resistant PCN or oral clindamycin (latter may more rapidly shut down toxin production)
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