TOXIC SHOCK SYNDROME

While the earliest described cases involved mostly menstruating women using highly absorbent tampons, only 55% of current cases are associated with menses. This illness may also occur in children and in men.

What is Toxic Shock Syndrome?

Toxic shock syndrome (TSS) is caused by a toxin produced by certain types of Staphylococcus aureus bacteria.

What are the Risk Factors involved with TSS?

Risk factors include:

  • Recent menstruation
  • Recent use of barrier contraceptives such as diaphragms and vaginal sponges
  • Vaginal tampon use (especially prolonged)
  • Recent child birth
  • Recent surgery
  • Current Staphylococcus Aureus Infection

How can Toxic Shock Syndrome be Prevented?

Menstrual TSS can be prevented by avoiding the use of highly absorbent tampons. Risk can also be reduced by using less absorbent tampons, and by using tampons only intermittently in the menstrual cycle.

What are the Symptoms of Toxic Shock Syndrome?

  • high fever sometimes accompanied by chills
  • profound malaise
  • nausea, vomiting and/or diarrhea
  • diffuse red rash resembling a sun-burn
  • rash followed in 1 or 2 weeks by peeling of the skin, particularly the skin of the palms or soles
  • redness of eyes, mouth, throat
  • confusion, seizures, headaches
  • myalgias (muscle aches)
  • hypotension
  • organ failure (kidneys, liver most commonly involved)

How is Toxic Shock Syndrome Diagnosed?

The diagnosis of toxic shock syndrome rests on several criteria which include: fever, low blood pressure (hypotension), rash, peeling after 1-2 weeks, and at least 3 organs with signs of dysfunction. In some cases, blood cultures may be positive for growth of Staphylococcus aureus.

How is Toxic Shock Syndrome Treated?

The management of toxic shock is largely supportive. It also requires examination for the presence of foreign material (e.g., tampons, vaginal sponges, nasal packing) and drainage of any identified site of infection (e.g., surgical wounds) to decrease the inflammatory state. Supportive measures are an essential aspect -- and may include intravenous fluids, blood pressure support, and dialysis (if severe kidney dysfunction is present). Antibiotic therapy is also used; and in some cases, intravenous immunoglobulin may be used as well.

Toxic shock may be fatal in up to 50% of cases and may recur.

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