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 General Gynecology, Infectious Diseases

Toxic shock syndrome

Toxic shock syndrome

Normal uterine anatomy (cut section)
Normal uterine anatomy (cut section)

Definition:

Toxic shock syndrome is a severe disease that involves fever, shock, and problems with the function of several body organs.

Alternative Names:
TSS; Staphylococcal toxic shock syndrome
Causes, incidence, and risk factors:

Toxic shock syndrome (TSS) is caused by a toxin produced by certain types of Staphylococcus bacteria. (A similar syndrome, called toxic shock–like syndrome (TSLS), can be caused by Streptococcus bacteria.)

Although the earliest described cases of TSS involved women who were using tampons during their periods (menstruation), only 55% of current cases are associated with menstruation. Toxic shock syndrome can also occur in children, postmenopausal women, and men.

Risk factors include:

  • Menstruation
  • Use of barrier contraceptives such as a diaphragm or vaginal sponge
  • Tampon use (particularly if you leave on in for a long time)
  • Foreign bodies or packings (such as those used to stop nosebleeds)
  • Childbirth
  • Surgery
  • Current Staphylococcus aureus (S. aureus) infection
Symptoms:
  • High fever, sometimes accompanied by chills
  • Malaise (discomfort, ill feeling)
  • Nausea
  • Vomiting
  • Diarrhea
  • Widespread red rash resembling a sunburn
  • Rash followed in 1 or 2 weeks by peeling of the skin, particularly on the palms of the hand or bottom of the feet
  • Redness of eyes, mouth, throat
  • Confusion
  • Seizures
  • Headaches
  • Muscle aches
  • Hypotension (low blood pressure)
  • Organ failure (usually kidneys and liver)
Signs and tests:

There is no one diagnostic test for TSS. The diagnosis of toxic shock syndrome is based on several criteria: fever, low blood pressure, rash that peels after 1-2 weeks, and at least 3 organs with signs of dysfunction. In some cases, blood cultures may be positive for growth of S. aureus.


Review Date: 9/6/2006
Reviewed By: Hilary M. Babcock, M.D., Medical Director of Occupational Infection Control, Barnes-Jewish and St. Louis Children's Hospitals; Instructor of Medicine, Infectious Disease Division, Washington University School of Medicine, St. Louis, MO. Review provided by VeriMed Healthcare Network.

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