What is the primary infectious agent responsible for toxic shock syndrome (TSS)?

Toxic shock syndrome (TSS) is primarily associated with Staphylococcus aureus, which produces exotoxins that can lead to the clinical manifestations of the syndrome. These toxins act as superantigens, activating a massive number of T cells and resulting in an overwhelming immune response. This hyperactivation leads to the release of extensive inflammatory mediators, causing the characteristic symptoms of TSS, which include high fever, rash, hypotension, and, in some cases, multi-organ failure.

Staphylococcus aureus is particularly associated with menstrual TSS related to the use of high-absorbency tampons but can also be involved in surgical wounds and other forms of tissue infection. The ability of Staphylococcus aureus to produce various toxins significantly contributes to its role as the primary infectious agent responsible for toxic shock syndrome.

In contrast, while Streptococcus pneumoniae, Escherichia coli, and Clostridium perfringens can cause severe infections, they are not typically linked to TSS. Streptococcus pyogenes, not pneumoniae, is another pathogen that can cause a similar syndrome known as streptococcal toxic shock syndrome, but it is distinct from the TSS more commonly associated with Staphylococcus