Clinical and fundamental studies of streptococcal toxic shock syndrome

: Streptococcal toxic shock syndrome(STSS) is known to progress rapidly into septic shock and multiple organ failure with frequently necrotizing fasciitis, and high mortality (approximately 40%). The diagnosis of STSS is confirmed based on the diagnosis criteria induced by the working group of the United State. Several extracellular products such as SPE A, B, and C having pyrogenic and superantigenic activity as well as SPE F, SPE G, H, J, SME Z, SME Z2, SSA are likely to involved in the pathogenesis of STSS. Recent studies have demonstrated an important role of certain cytokines, such as TNF-alpha, in laboratory animals. The exact role of such products in the pathogenesis of STSS, however, is currently unknown. The role of several virulence factors of group A streptococci in the pathogenesis of STSS was discussed in this review.