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Sepsis and Toxic Shock Syndrome

Sepsis is also called Systemic inflammatory response syndrome (SIRS). Sepsis is a severe illness caused by overwhelming infection of the bloodstream by toxin-producing bacteria.

Many types of infection can cause hypotension and a sepsis syndrome. The elderly and immunocompromised are particularly susceptible to infectious insults and may show early compromise. Common sources for infection should be considered, including genitourinary, abdominal for CNS, and pulmonary. Toxic shock syndrome (TSS) is mediated by Staphylococcus aureus exotoxins causing multiorgan system dysfunction. Although it is widely known to occur in women using tampons, TSS can occur in males and children, and in nonmenstrual females. Fever, rash, and hypotension are the most prominent features of TSS.


Sepsis is caused by a bacterial infection. The bacterial infection can originate anywhere in the body. The most common areas the infection originates from are:

  • Kidneys
  • Liver
  • Gall bladder
  • Bowel

Toxic shock syndrome (TSS) is caused by a toxin produced by certain types of staphylococcus bacteria. Although the earliest described cases involved mostly menstruating women using highly absorbent tampons, only 55% of current cases are associated with menstruation. The illness can also occur in children, postmenopausal women, and men.


  • Symptoms specific to focus of infection
  • Weakness
  • Fever
  • Rash (desquamation in TSS; petechial rash may occur in meningococcemia)
  • Diarrhea (++++ in TSS)
  • Myalgias (+++++ in TSS)
  • Vomiting(++++ in TSS)
  • Headache (++++ in TSS)
  • Sore throat (+++ in TSS)
  • Vaginal discharge (++ in TSS)
  • Rigors (++ in TSS)


  • Signs specific to site of infection
  • Toxic shock: rash (diffuse macular erythroderma +++++)
  • Fever >38.5° C (may be hypothermic in some septic patients)


Treatment of sepsis will depend on where the infection originated. In order to do this, the source of the infection must be found.

If you develop toxic shock syndrome, you'll likely be hospitalized and need antibiotics. Doctors will try to determine the source of the infection. Along with antibiotics, you'll receive supportive care to treat the signs and symptoms of toxic shock syndrome. If your blood pressure begins to drop (hypotension), you'll need medication to stabilize it and fluids to prevent dehydration. The toxins produced by the staph bacteria may result in kidney failure. If your kidneys fail, you may need dialysis.


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