True about TSS -

. Ans. is 'a' i.e. Most commoly due to TSST-1 . Toxic shock syndrome is most commonly caused by toxic shock syndrome toxin type-I (TSST-I), which is a superantigen produced by Staphylococcus aureus. . Option 'b' is tricky one . First read following statement. "Toxic shock syndrome (T-S.S.) was first recognized as a disease in children in 1978, but disease gained national attention in early 1980 following outbreaks in the USA in menstruating women using highly absorbent vaginal tampons withdrawl of tampon from the market resulted in a rapid decline in the incidence of this disease". . Do not misinterpret this statement - mensturation as such is not a risk factor, rather mensturating women which use vaginal tampons were at risk and vaginal tampons were responsible for TSS in mensturating women. If mensturation would have been a risk factor, then every women in reproductive age would be at risk for TSS, which is not the case. So, option 'b' is wrong. . Anti- staphylococcal antibodies are used in the treatment of TSS. Treatment of TSS The severity of this disease frequently warrants hospotalization. Admission to the intensive care unit is often necessary for suppoive care (for aggressive fluid management, ventilation, renal replacement therapy and inotropic suppo), paicularly in the case of mutliple organ failure. Antibiotic treatment should cover both S. pyogenes and S. aureus.This may include a combination of cephalosporins, penic ill ins or vancomycin. The addition of clindamycin or gentamicin reduces toxin production and moiality.