Toxic Shock Syndrome (TSS) refers to a combination of symptoms that result from an infection caused by Staphylococcus aureus. The disease progresses, causing failure of multiple body systems. Toxic shock syndrome can be fatal. There are two types of the disease:
The Menstrual Type – associated with menstruation and tampon use. The number of tampon-associated cases has decreased since the 1980s. Women have become more aware of the danger and modified their use of tampons. In addition, a highly absorbent type of tampon was removed from the market. Doctors are not sure what role tampons play in the disease. Absorbent tampons may cause dryness and breaks in the lining of the vagina.
The Non-Menstrual Type – associated with a wound. It can occur in men, women and children.
Different bacteria, Streptococcus pyogenes, can cause a similar condition called streptococcal Toxic Shock-like Syndrome.
Causes
Staphylococcus aureus bacteria produce toxins. The immune systems in most adults have built up antibodies to fight this common bacteria. In people who do not have the antibodies, the toxins can damage multiple body systems.
Risk Factors
A risk factor is something that increases your chances of getting a disease or condition.
- Sex: Female
- Youth
- Not having antibodies to toxic shock syndrome toxins
- Tampon use
- Birth control devices placed in the vagina:
- Sponge
- Diaphragm
- Cervical cap
- Skin lesions, such as burns or insect bites
- Nasal surgery, with packing
- Surgical wounds
- Recent childbirth
- Immunity problems, such as diabetes or AIDS
Symptoms
Symptoms usually come on suddenly. Some patients may have fever, chills and body aches for up to four days prior to other symptoms developing. Wounds in the nonmenstrual type do not appear infected.
Symptoms of both types include:
- Fever of 102 degrees F
- Sunburn-like rash
- Low blood pressure
- Shock
- Chills
- Nausea
- Vomiting
- Diarrhea
- Abdominal pain
- Sore throat
- Red eyes
- Headache
- Confusion
- Agitation
- Sleepiness
- Joint or muscle pain
- Vaginal discharge (may be watery or bloody)
- Swelling in the face and eyelids
- Skin peeling off, especially palms of hands and soles of feet
The initial symptoms may improve, but the disease progresses and causes multiple organs to fail. Symptoms of severe TSS include:
- Little or no urine production
Seriously low blood pressure
- Difficulty breathing
- Seizures
- Gangrene
- Pancreatitis
- Heart problems
- Fluid retention
Diagnosis
The doctor will perform a physical and pelvic exam. The doctor may test tissue in your vagina or in a wound that could be the source of the bacteria. Although these tests are often done, they are usually negative. The diagnosis is based on the fever, the rash, low blood pressure and problems affecting multiple body systems. Other tests may be done to rule out other medical conditions.
Treatment
Treatment aims to support your life and reverse the process of organ deterioration. You may require monitoring in the intensive care unit.
Treatment includes:
Cleaning and Draining the Infection Site
The doctor irrigates open wounds and removes any packing. If a tampon or birth control device is in the vagina, the doctor takes it out.
Replacing Fluids
You will be given an infusion of fluids to replace lost fluids.
Medications
Medications help raise blood pressure that does not improve after an infusion of fluids. Other drugs may help in lowering fever. Antibiotics do not cure TSS, but they may help prevent a recurrence.
Respirators
Artificial breathing with a machine may be needed.
Dialysis
Some patients may require dialysis
Prevention
Strategies to decrease your risk of
Toxic Shock syndrome include:
- Do not use tampons continuously when menstruating.
- Alternate using a tampon with a sanitary pad.
- Switch to sanitary pads at night.
- Do not use super absorbency tampons.
- Change tampons frequently during the day.
- Store tampons in a clean, dry place.
- Wash your hands with soap and water before and after you put in or take out a tampon.
- Use a lower absorbency tampon if you find the tampon is irritating or hard to pull out.
- Use tampons only during menstruation.
- Seek medical care for infected wounds.
- If you have had toxic shock syndrome, do not use tampons or place birth control devices in your vagina.