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Toxic Shock Syndrome

Toxic shock syndrome, or TSS, is an acute, life­threatening condition that affects 1 in 100,000. TSS primarily affects young individuals. In the early convalescent period, it's characterized by fever, hypotension, rash, multiorgan dysfunction, and desquamation.

Causes

Staphylococcus aureus bacteria produce the toxin that causes Toxic Shock Syndrome. The immune system in many adults have developed antibodies to fight these common bacteria. In people who don't have the antibodies, the toxins can damage multiple body systems.

Symptoms and Signs

The signs and symptoms of toxic shock syndrome may include:

  • High fever.
  • Vomiting
  • Diarrhea.
  • Confusion.
  • Muscle aches.
  • Redness of your eyes, mouth and throat.
  • Seizures.
  • Headaches.

Diagnostic tests

Isolation of S. aureus from vaginal discharge or the infection site helps support the diagnosis, but a confirmed diagnosis must follow the criteria set by the Centers for Disease Control and Prevention.

Negative results on blood tests for Rocky Mountain spotted fever, leptospirosis, and measles help rule out these disorders. Common laboratory abnormalities include azotemia, hypoalbuminemia, hypocalcemia, hypophosphatemia, elevated creatinine kinase level, leukocytosis or leukopenia, thrombocytopenia, and pyuria.

Treatment

Appropriate treatment may consist of I.V. antistaphylococcal antibiotics, such as clindamycin oxacillin, nafcillin, and methicillin. To reverse shock, the patient needs fluid replacement with saline solution and colloids.

Sustained hypotension that is unresponsive to fluids should be treated with vasopressors, and electrolyte imbalances should be corrected. I.V. immunoglobulin may be considered for severe cases.

Other measures may include supportive treatment for diarrhea, nausea, and vomiting.

Prevention

You can reduce your chances of getting toxic shock syndrome by changing your tampon frequently, at least every four to eight hours. Use the lowest absorbency tampon you can and try to alternate using tampons and sanitary napkins whenever possible.

Toxic shock syndrome can recur. People who've had it once can get it again. If you've had toxic shock syndrome or a prior staph infection, don't use tampons at all.

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