Toxic Shock Syndrome

Toxic shock syndrome (TSS) is a rare but life-threatening acute bacterial infection caused by Staphylococcus aureus and Streptococcus pyogenes bacteria. The symptoms of TSS begin with a sudden high fever followed by flu-like symptoms including headache, muscle aches, sore throat and cough, nausea and vomiting, diarrhea and a widespread, flat, red skin rash that rapidly develop in the course of a few hours. The risk of TSS is greater in children and women. The incidence of TSS is rare in the United Kingdom. The average number of cases per year is 40 (out of a population of 60 million). The risk of TSS is greater in children and menstruating women. 

TSS is a medical emergency and the patient needs to be treated immediately. Early and immediate treatment should including fluid resuscitation, empirical antibiotic therapy should be done. In case of unconfirmed suspected TSS broad spectrum antibiotics like clindamycin+ carbapenem/beta-lactamase inhibitor/vancomycin must be administered. Confirmed streptococcal TSS needs treatment with benzylpenicillin and clindamycin. Patients must be educated about proper use of tampons, maintenance of personal hygiene during menstruation.