Toxic Shock Syndrome Definition

Toxic Shock Syndrome is a systemic immune response to the endotoxins many bacteria produce during infections. The immune response produces widespread, significant inflammation involving multiple organ systems. Staphylococcal toxic shock syndrome, resulting from Staphylococcus aureus infection, is more common and causes milder illness.

Streptococcal toxic shock syndrome, which results from group A betahemolytic streptococcal bacteria, produces severe illness and causes death in about 60 percent of people who develop it.

Symptoms

Symptoms are those of acute bacterial infection such as fever and pain, with hypotension (low blood pressure) and rash that involves the entire body, including the palms of the hands and soles of the feet.

Illness is severe enough to require hospitalization, often in an intensive care unit, for supportive medical care (including fluid replacement, cardiovascular stabilization, and mechanical ventilation as necessary) and treatment with intravenous immunoglobulin and antibiotic medications.

Complications of toxic shock syndrome are potentially life-threatening and include disseminated intravascular coagulation (DIC)acute respiratory distress syndrome (ARDS), and necrotizing fasciitis. People who recover from toxic shock syndrome may have lingering health problems and are at risk for recurrence.

Toxic Shock Syndrome Tampon Use and History

Toxic shock syndrome first emerged as a significant health issue in the 1980s when superabsorbent tampons new on the market caused an outbreak of toxic shock syndrome among otherwise healthy women. The superabsorbency of the tampons meant women could change them less frequently, an unexpected side effect of which was a spike in bacterial infections.

Changes in tampon materials and widespread education efforts have significantly reduced toxic shock syndrome due to tampon use, although tampon use remains a risk factor. Other risks include surgical packing (such as after an operation on the nose) and illness due to common bacterial infections.

See also SCARLET FEVERSTREP THROATSEPTICEMIA.

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