Toxic Shock Syndrome

Toxic shock syndrome (TSS) is a rare but life-threatening acute bacterial infection caused by Staphylococcus aureus and Streptococcus pyogenes bacteria. It can occur after surgical wound infection, postpartum infection, cutaneous, subcutaneous infection or after pulmonary staphyloccal infections. Symptoms include high fever, hypotension, rash with diffuse macular erythroderma, vomiting and diarrhea, myalgia, renal dysfunction etc. Exotoxins released from S. aureus including toxic shock syndrome toxin-1 (TSST-1), enterotoxins A, C, D, E and H and Streptococcal pyrogenic exotoxins A, B and C activate the immune system to release massive quantities of inflammatory cytokines with increase in capillary permeability, tissue damage, shock and multiorgan failure. 

TSS is a very rare disorder. Studies across the world indicate that it occurs in 1 person in every 100,000. It affects persons of all ages.Post-partum women and menstruating women are at a higher risk.TSS needs immediate medical assistance. Antibiotics (Clindamycin+broad spectrum beta lactum) and intravenous immunoglobulins assist in neutralizing circulating toxins. Supportive care like fluid supplement and dialysis help the patient recover quickly.Women should be advised to avoid the use of soaps, shower gels, bubble baths, shampoos and antiseptics around the genital area. Menstrual TSS can be prevented by avoiding the use of highly absorbent tampons.