Toxic shock syndrome is a life-threatening illness mediated by toxins secreted in the blood by either Staphylococcus aureus or group A Streptococcus bacteria.
When poisonous toxins are released in the bloodstream, they can damage skin tissue and harm vital organ functions, such as lung, liver and renal.
Toxic shock syndrome can affect anyone. It was first reported in children in 1978, but many years later it was identified in women who were using tampons during their menstrual periods. However, after the withdrawal of highly absorbent tampons from the market, the number of toxic shock syndrome cases associated with the use of tampons has declined. In fact, 50 percent of TSS cases are not associated with menstruation. The syndrome can occur in women, men and children of all ages.
Risk factors for TSS are recent childbirth, skin infections, cuts and burns, wound infection after surgery, viral infections, like flu or chickenpox, using foreign body items such as contraceptive sponges, diaphragms, super absorbent tampons and nasal packings.
TSS is characterized by sudden high fever, rash resembling a sunburn, especially on palms and soles, and peeling skin generally one to two weeks after the onset of acute illness. Other signs are low blood pressure; eyes, mouth and throat redness, vomiting or diarrhea, seizures, confusion, headaches and muscle aches.
There is currently no test used to identify TSS. Clinicians can make a diagnosis based on a physical examination and the patient’s symptoms. Some examinations might include blood tests to check organ function or swab samples from the cervix, vagina and throat.
Treatment includes removal of foreign bodies and drainage of infections. The goal of the treatment is to maintain important body functions with the use of antibiotics to fight bacterial infections, dialysis, intravenous therapy and medicines to control blood pressure. Patients with a severe condition might need to stay in the hospital intensive care unit for monitoring.
It is recommended to see a doctor immediately if there are any signs of TSS, particularly if the person has a wound or skin infection or recently used tampons. TSS is a medical emergency that can cause death if untreated. There can be complications such as liver, kidney and heart failure, and shock or reduced blood flow through the body.
TSS can recur. To lower the risk of menstrual TSS it is recommended to avoid highly absorbent tampons, to change tampons frequently and alternate using tampons and sanitary napkins.
Joanne Brown is an Adjunct Instructor in the University of Kentucky College of Nursing and Women’s Health Nurse Practitioner at University Health Service.