Toxic Shock Syndrome
Toxic shock syndrome is a group of severe symptoms, including dangerously low blood pressure, usually caused by toxins produced by staphylococci (and sometimes streptococci).
Toxic shock syndrome is the result of toxins produced by bacteria, usually staphylococci. The toxins may come from bacteria infecting the body or from bacteria simply growing on the body--for example, in a tampon (especially the high-absorbant type) held in the vagina. Certain types of super-absorbant tampons, particularly those containing polyacrylate, have been removed from the market because of this.
The toxin may enter the blood through small cuts in the vaginal lining or through the uterus into the abdominal cavity. However, toxic shock syndrome also occurs in women who do not use tampons and in men. Although the strain of Staphylococcus that causes most cases of toxic shock syndrome is known, the event that triggers the syndrome is not. A person who has had toxic shock syndrome is at increased risk of developing it again.
Symptoms and Diagnosis
Symptoms start suddenly with a fever of 102 to 105° F. A severe headache, sore throat, red eyes, extreme tiredness, confusion, vomiting, profuse watery diarrhea, and a sunburn-like rash all over the body quickly develop. Within 48 hours, the person may also faint and develop dangerously low blood pressure (shock). Between the third and seventh day, the skin peels, particularly on the palms and soles.
Toxic shock syndrome affects many parts of the body. Damage to the kidneys, liver, and muscles is very common, especially during the first week. Heart and lung problems, as well as anemia, may also develop. Most organs recover fully after the symptoms disappear.
The diagnosis is usually based on the person's symptoms. Although there is no laboratory test available that specifically identifies toxic shock syndrome, blood tests usually are performed to look for other possible causes of the symptoms.
Prevention, Treatment, and Prognosis
There are no recommendations for preventing toxic shock syndrome in women who do not wear tampons or in men. Tampon-related disease is less likely in women who avoid constant tampon use during menstruation. Because of their association with toxic shock syndrome, super-absorbant tampons should not be used when the menstrual flow is mild or moderate.
Ideally, a person suspected of having toxic shock syndrome is hospitalized immediately. Tampons, diaphragms, and other foreign objects are removed from the vagina, and antibiotic therapy is started.
About 8 to 15% of people with severe toxic shock syndrome die. Recurrences are common in women who continue to use tampons in the 4 months after an episode of toxic shock syndrome, unless antibiotic treatment has eliminated the staphylococci.
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