Toxic shock syndrome

- associated with tampon use in menstruating women and surgical wound infection
- caused by Staph.aureus (producing TSST-1) or Strep.pyogenes
- presents with fever, diffuse macular rash over palm and soles (followed by desquamation after 1-2 week), hypotension, multiorgan failure
- treatment: flucloxacillin + clindamycin
- although clindamycin is a bacteriostatic antibiotic, it acts by switching off protein synthesis within bacteria which lead to decreased exotoxin expression thereby removing mediators of TSS