Toxic shock syndrome (TSS)

1. Toxic shock syndrome (TSS)

2. - is a serious but uncommon bacterial infection. TSS was originally linked to the use of tampons, but is now also known to be associated with the contraceptive sponge and diaphragm birth control methods. TSS has also resulted from wounds secondary to minor trauma or surgery incisions where bacteria have been able to enter the body and cause the infection.

3. Possible signs and symptoms of toxic shock syndrome include: • A sudden high fever • Low blood pressure (hypotension) • Vomiting or diarrhea • A rash resembling a sunburn, particularly on your palms and soles • Confusion • Muscle aches • Redness of your eyes, mouth and throat • Seizures • Headaches

4. There are two types of this condition. The first, toxic shock syndrome, is caused by Staphylococcus aureus bacteria and has been associated with the use of tampons. (TSS was initially linked to a particular type of tampon, which has since been taken off the market.) Although the exact connection is still not clear, researchers suspect that certain types of high-absorbency tampons provided a moist, warm home where the bacteria could thrive.

5. -TSS can affect anyone who has any type of staph infection, including pneumonia, abscess, skin or wound infection, a blood infection called septicemia, or a bone infection called osteomyelitis.

6. -The second type of related infection, streptococcal toxic shock syndrome, or STSS, is caused by streptococcus bacteria. Most often STSS appears after streptococcus bacteria have invaded areas of injured skin, such as cuts and scrapes, surgical wounds, and even chickenpox blisters. • Toxic shock syndrome from staphylococcus starts suddenly with vomiting, high fever (temperature at least 102° Fahrenheit [38.8° Celsius]), a rapid drop in blood pressure (with lightheadedness or fainting), watery diarrhea, headache, sore throat, and muscle aches.

7. Within 24 hours, a sunburn-like rash appears. There also may be bloodshot eyes and an unusual redness under the eyelids or inside the mouth (and vagina in females). After that, broken blood vessels may appear on the skin. Other symptoms may include: confusion or other mental changes; decreased urination; fatigue and weakness; thirst; weak and rapid pulse; pale, cool, moist skin; and rapid breathing.

8. Prevention: • -The bacteria that cause toxic shock syndrome can be carried on unwashed hands and prompt an infection anywhere on the body. So hand washing is extremely important. • The risk of TSS can be reduced by either avoiding tampons or alternating them with sanitary napkins. Girls who use only tampons should choose ones with the lowest absorbency that will handle menstrual flow and change the tampons frequently. Between menstrual periods, store tampons away from heat and moisture (where bacteria can grow) — for example, in a bedroom rather than in a bathroom closet.

9. -Because staphylococcus bacteria are often carried on dirty hands, it's important for girls to to wash their hands thoroughly before and after inserting a tampon. If your daughter is just starting her menstrual period, she should know about taking these precautions. Any female who has recovered from TSS should check with her doctor before using tampons again

11. Risk factors • Toxic shock syndrome can affect anyone. About half the cases of toxic shock syndrome occur in menstruating women; the rest occur in older women, men and children. • Toxic shock syndrome has been associated with:

12. Having cuts or burns on your skin • Having had recent surgery • Using contraceptive sponges, diaphragms or superabsorbent tampons • Having a viral infection, such as the flu or chickenpox

13. Diagnosis and Treatment: • -There's no one test for toxic shock syndrome. You may need to provide blood and urine samples to test for the presence of a staph or strep infection. Your vagina, cervix and throat may be swabbed for samples for laboratory analysis. • Because toxic shock syndrome can affect multiple organs, your doctor may order other tests, such as a CT scan, lumbar puncture or chest X-ray, to assess the extent of your illness

14. Treatment: • Antibiotics while doctors seek the infection source • Receive medication to stabilize your blood pressure if it's low (hypotension) and fluids to treat dehydration • Receive supportive care to treat other signs and symptoms • The toxins produced by the staph or strep bacteria and accompanying hypotension may result in kidney failure. If your kidneys fail, you may need dialysis. • Surgery may be necessary to remove nonliving tissue (debridement) from the site of infection or to drain the infection

15. Prevention • Manufacturers of tampons sold should no longer use the materials or designs that were associated with toxic shock syndrome. • If you use tampons, read the labels and use the lowest absorbency tampon you can. Change tampons frequently, at least every four to six hours. • Toxic shock syndrome can recur. People who've had it once can get it again. If you've had toxic shock syndrome or a prior serious staph or strep infection, don't use tampons.