Toxic Shock Syndrome

Toxic shock syndrome (TSS) is a rare but potentially fatal disease caused by a bacterial exotoxins produced by Staphylococcus aureus and few strains of Streptococcus. It is characterized by high fever, rash, hypotension, multiorgan involvement, and desquamation. Multisystem involvement may cause vomiting, diarrhea, myalgia, mental confusion, renal dysfunction, hepatic abnormalities, and thrombocytopenia. TSS is relatively rare. The worldwide prevalence of TSS is approximately 3/100,000 people. Mortality associated with TSS is 5-10% in children, much lower than in adults (30-80%). TSS is most commonly associated with women who use high-absorbency tampons. 

Management of a TSS includes hemodynamic stabilization and antibiotic therapy (clindamycin+carbapenem/beta-lactamase inhibitor/vancomycin) to eradicate the bacteria. Supportive therapy, aggressive fluid resuscitation is necessary. An adjuvant therapeutic strategy with agents like immunoglobulin can be done. The link between TSS and tampon use is not clearly known, but many studies suggest that tampon absorbency may be a factor for infection. The best way to prevent TSS is to get proper treatment for wounds on the body and correct use tampons and contraception.