Toxic Shock Syndrome
Toxic shock syndrome (TSS) is a rare but potentially life-threatening condition caused by certain strains of bacteria that produce poisons (toxins). These toxins get into your bloodstream and can affect organs such as your heart, liver or kidneys. It’s often associated with using tampons during menstruation. However, TSS can affect anyone of any age. Skin wounds, surgical incisions, nasal packing, scrapes, burns or other areas of injured skin can increase the risk of the condition. Half of all cases are unrelated to menstruation.
The symptoms of TSS happen suddenly and worsen quickly. However, most people recover if TSS is diagnosed and treated quickly.
Symptoms
Some signs and symptoms of toxic shock syndrome to look out for include –
• A high fever that spikes suddenly
• Low blood pressure
• Throwing up or frequent, watery stools
• A rash that looks like a sunburn, especially on your palms and bottoms of your feet
• Confusion
• Muscle aches
• Red eyes, mouth, and throat
• Seizures
• Headaches
If you’re menstruating and have a high fever with vomiting, especially if you‘ve been using tampons, you must get medical help right away. If you’re using a tampon, menstrual sponge, diaphragm, or cervical cap when you get ill, remove it immediately, even before calling your doctor.
Causes
Most commonly, Staphylococcus aureus (staph) bacteria cause toxic shock syndrome. The syndrome can also be caused bystreptococcus pyogenes( group A streptococcus) bacteria.
Under certain conditions, some strains of bacteria may start to grow rapidly and produce toxins. When you use a tampon, Staphylococcus aureus (staph) bacteria may become trapped in your vagina and enter your uterus via your cervix.
Bacteria may grow on tampons, especially if they aren’t changed often enough. Bacteria may also grow if your menstrual flow is light and you use a super-absorbent tampon. Tampons can also cause tiny cuts in your vagina, and bacteria can enter your bloodstream.
Toxic shock syndrome can occur when bacteria gets into open wounds, cuts or sores on your body. This can be from a skin infection, surgery, childbirth or a nosebleed that requires packed gauze to stop it.
Risk factors
Toxic shock syndrome can affect anyone. About half the cases of toxic shock syndrome associated with staphylococci bacteria occur in women of menstruating age; the rest occur in older women, men and children. Streptococcal toxic shock syndrome occurs in people of all ages.
Toxic shock syndrome has been associated with:
• Having cuts or burns on your skin
• Having had recent surgery
• Nasal packing
• Compromised immune system
• Using contraceptive sponges, diaphragms, superabsorbent tampons or menstrual cups
• Having a viral infection, such as the flu or chickenpox
Complications
Toxic shock syndrome can progress rapidly. Complications may include:
• Shock
• Coagulopathy
• Renal failure
• Liver failure
• Heart failure
• Death
Diagnosis
Your doctor may make a diagnosis of TSS based on a physical examination and your symptoms. A diagnosis can be made through –
• a blood or urine test checking for bacteria
• a blood test to check liver and kidney function
• a CBC (complete blood count) testing for white blood cell count or a decrease in platelets
• taking swabs of cells from the cervix, vagina, and throat
• analyzing samples for bacteria that cause TSS
• a coagulation study to evaluate blood clotting ability
Treatment
Treatment typically involves hospitalization due to the potentially life-threatening nature of toxic shock syndrome. You’ll be given intravenous (IV) fluids and possibly medications to raise your blood pressure if it’s low.
Treatment for TSS may involve –
• Antibiotics to treat the infection.
• Purified antibodies taken from donated blood (known as pooled immunoglobulin) to help your body fight the infection.
• Oxygen to help with breathing.
• Fluids to prevent dehydration and organ damage.
• Medicine to help control blood pressure.
• Dialysis if your kidneys stop functioning.
• Surgery to remove dead tissue. Rarely, it may be necessary to amputate the affected area.
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