Toxic shock syndrome
Toxic shock syndrome (TSS) is a rare but potentially fatal disease caused by a bacterial toxin. Different bacterial toxins may cause toxic shock syndrome, depending on the situation. The causative agent is Staphylococcus aureus. A similar condition, therefore called Toxic Shock Like Syndrome (TSLS), is the result of Streptococcus pyogenes infection more...
Point of Entry
The route of infection is usually through the skin (pricking accident, surgery, burns), vagina (tampon, partus) or pharynx.
The number of reported toxic shock syndrome cases has decreased significantly in recent years. Approximately half the cases of TSS reported today are associated with tampon use during menstruation, usually in young women, though TSS also occurs in children, men, and non-menstruating women. In the US in 1997 only five confirmed menstrually-related TSS cases were reported, compared with 814 cases in 1980, according to data from the Centers for Disease Control and Prevention (CDC).
Although scientists have recognized an association between TSS and tampon use, no firm causal link has been established. Research conducted by the CDC suggested that use of some high absorbency tampons increased the risk of TSS in menstruating women. A few specific tampon designs and high absorbency tampon materials were also found to have some association with increased risk of TSS. These products and materials are no longer used in tampons sold in the U.S. Tampons made with rayon do not appear to have a higher risk of TSS than cotton tampons of similar absorbency.
Vaginal dryness and ulcerations may occur when women use tampons more absorbent than needed for the amount of their menstrual flow. Ulcerations have also been reported in women using tampons between menstrual periods to try to control excessive vaginal discharge or abnormal bleeding. Women may avoid problems by choosing a tampon with the minimum absorbency needed to control menstrual flow and using tampons only during active menstruation. Alternately, women may use a silicone menstrual cup to avoid the negative side-effects of tampons.
Symptoms and diagnosis
Symptoms of toxic shock syndrome in the early phase can be hard to recognize because they mimic the flu. They include sudden high fever, muscle aches, joint pain, vomiting, diarrhea, dizziness, fainting, or a rash that looks like a sunburn. One or two weeks after initial symptoms begin, flaking and peeling of the skin occurs, mainly on the palms and soles.
The fulminant course rapidly changes general symptoms to fever, systolic blood pressure under 90 mmHg, altered state of mind. In other words, septic shock.
Women wearing a tampon at the onset of symptoms should remove it immediately. The severity of this disease results in hospitalisation for treatment. Antibiotic treatment consists of Penicilline and Clindamycin.
Extreme infection of the skin and deeper parts is called Fasciitis necroticans, (one of the symptoms), and should be attacked surgically without delay.
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