Streptococcal toxic shock syndrome is due to liberation of

Pyrogenic exotoxin ( erythrogenic, Dick, scarlatinal toxin): the toxin was named erythrogenic because it's intradermal injection into susceptible individuals produced an erythematous reaction. The primary effect of the toxin is induction of fever and so it was renamed streptococcal pyrogenic exotoxin. 3 types of SPE have been identified: A, B, and C, types A and C are coded by bacteriophage genes while type B gene is chromosomal. SPE are superantigens, T cell mitogens that induce a massive release of inflammatory cytokines, causing fever, shock and tissue damage. Soft tissue infections with some eM types 0f S.pyogenes (1, 3, 12, 28) may sometimes cause a toxic shock syndrome resembling staphylococcal TSS. Reference: Textbook of Microbiology; Anathanarayan and paniker's; 10th edition; Page no: 214, 215