What is streptococcal toxic shock syndrome?

Streptococcal toxic shock syndrome is a rare but extremely severe illness characterized by hypotension (low blood pressure) and shock. Other symptoms can include renal (kidney) impairment, coagulopathy (abnormality in the blood's ability to clot), adult acute respiratory distress syndrome, rash and local tissue destruction. Death occurs in up to 70% of people who develop streptococcal toxic shock syndrome.

There are two types of toxic shock syndrome. This fact sheet describes that type caused by group A streptococcal infections. The other kind of toxic shock syndrome is caused by Staphylococcus aureus and it is described on the Toxic Shock Syndrome fact sheet.

Who gets streptococcal toxic shock syndrome?

Streptococcal toxic shock syndrome occurs in some people who have group A streptococcal infections. People who have recently had surgery or women who have recently given birth may be at higher risk for developing streptococcal toxic shock syndrome.

How is streptococcal toxic shock syndrome spread?

Group A streptococcal infections may be spread from one person to another by large respiratory droplets (coughing or sneezing) or by direct contact. Streptococcal toxic shock syndrome, however, is not spread from one person to another.

It is possible for people to carry and spread group A streptococcal infections without ever being sick themselves.

What are the symptoms of streptococcal toxic shock syndrome?

People who have streptococcal toxic shock syndrome will have group A streptococcal bacteria isolated from their bodies. They will also have hypotension and two or more of the following signs:

For an illness to be called streptococcal toxic shock syndrome, there must also be no other bacteria or virus identified as a more likely cause of the illness.

How soon after exposure do symptoms appear?

For many people with streptococcal toxic shock syndrome, the time when they are first exposed to group A streptococcal bacteria is unknown. When the time of exposure is known, the time from exposure to onset of symptoms is 2-5 days.

How is streptococcal toxic shock syndrome diagnosed?

A physician is needed to properly diagnose streptococcal toxic shock syndrome.

What is the treatment for streptococcal toxic shock syndrome?

People with streptococcal toxic shock syndrome are treated for any symptoms or complications they may have. Any cause of infection (i.e., wound or foreign body) should be removed as quickly as possible. Doctors will also prescribe antibiotics to treat the infection.

How can streptococcal toxic shock syndrome be prevented?

People who are known to have group A streptococcal infections should be treated with antibiotics as soon as possible even if the bacteria is not making them sick, because of the possible risk of them spreading it to someone else.

Where can I get more information?

UTAH DEPARTMENT OF HEALTH
BUREAU OF EPIDEMIOLOGY
August 2001