Toxic Shock Syndrome

Toxic shock syndrome is an uncommon but severe acute illness with fever, widespread red rash accompanied by involvement of other body organs. Toxic shock syndrome is a medical emergency that requires prompt treatment.

Toxic shock syndrome (TSS) is a multisystem illness caused by an exotoxin usually produced by certain strains of S. aureus. The site of the S. aureus infection is often a tampon (85%), catheter, nasal packing, or other foreign body.

Causes

Toxic shock syndrome (TSS) is caused by a toxin produced by certain types of staphylococcus bacteria. Although the earliest described cases involved mostly menstruating women using highly absorbent tampons, only 55% of current cases are associated with menstruation. The illness can also occur in children, postmenopausal women, and men.

Symptoms

• Fever
• Chills
• Dizziness
• Myalgias
• Headache
• Red, nonpruritic rash that includes the palms and soles

Signs

• Diffuse, nonpruritic, blanching macular (or maculopapular or petechial) erythematous rash
• Patient may appear clinically ill with hypotension and other clinical signs of shock.
• Desquamation of skin (usually hands or feet) may occur by the second to fifth day.

Diagnosis

In addition to a medical history and physical exam, your physician may recommend bacterial cultures of any wounds and blood tests.

Treatment

The treatment of TSS includes antibiotics, blood pressure medications, and treatment of skin infections or wound abscesses. Additional treatments will depend on which organs have been affected. Despite treatment approximately 5-15% of individuals will not survive. Prompt diagnosis and treatment are key to reducing the severity of TSS.

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.