Toxic shock syndrome is an acute medical condition caused by a bacterial infection. It can be potentially life-threatening disease. A common pathogen that survives mutedly on the skin sometimes develops into a serious infection.
Staphylococcus Aureus or Streptococcus Pyogenes of group ‘A’ category is an infectious bacterium that causes this grave disease. Bacterial infection caused by Streptococcus Pyogenes is also called GAS. This same bacterium triggers strep throat.
TSS toxins travel through the blood stream and infect various parts of the body, in severe case this leads to multi-organ failure and destruction of tissues. As these contaminants passes through the bloodstream, it tends to over-stimulate the body’s immune system. Studies suggest TSS association with the use of superabsorbent tampons by menstruating women.
It is seen that toxic shock syndrome tampons cases amount to 50%. However, over the years, percentage of TSS has reduced. This is attributable to the increase of awareness about the illness and number of superabsorbent tampon brands being pulled out of the market.
Difference and effect of Streptococcal toxic shock syndrome and Staphylococcal toxic shock syndrome.
Major difference between the two is the blood cultures. They are positive in Staphylococcal TSS compared to Streptococcal TSS. Patients suffering from alcoholism, varicella infection and diabetes are at higher risk of contracting the Streptococcal TSS. Staphylococcal TSS usually causes menstrual related TSS.
In most Streptococcal TSS cases, pyrogenic exotoxins like A, B and C and STSS super antigens form chain like structure and destroy soft tissues in the body. Majority of Streptococcal infections are invasive infections, example infections that develop post surgery. Staphylococcal TSS (TSST-1) causes more than 50% of menstrual or non-menstrual related cases. Staphylococcal TSS is a gram-positive bacterium, generally found in the nasal and skin openings and the Staphylococcal enterotoxin B is the second top cause of TSS.
Causes of TSS
TSS affects men, women, postmenopausal women and children. Apart from use of tampons, TSS may develop due to,
- Severe skin infections
- Post surgery exposure
- Skin burn
- Infected wound
- Contraceptives used by women, as vaginal sponge or diaphragm
- Nasal packing
- Skin infection like chicken pox
- Toxic shock syndrome symptoms
- High fever (over 102 degree F) accompanied by two or three of the following
- Headache or muscle ache
- Low blood pressure (< 90mmhg) (Hypotension)
- Redness of eyes, throat and mouth
- Diarrhea or abdominal pain
- Dizziness or fainting
- Organ failure (particularly kidney)
In serious cases, renal failure might occur and last but not the least a major sign or symptom is toxic shock syndrome rash. It looks like sunburn, red in color, spreads all over the body. However, unlike boils it does not elevated and usually turns white in color when pressed. Once the rash development finishes it course, desquamation occurs, that is the skin particularly on the soles and palms starts to peel off.
Toxic shock syndrome treatment
Two main objectives in treating TSS are treating the sources of the infection and the organs or body functions that have been affected by the disease. Treatment only through pills does not work and hence warrants admission to an intensive care unit. Depending on the severity of the disease, patients may be administered antibiotics through intravenous like penicillin’s, vancomycin, gentamicin etc.
Women using tampons and experiencing TSS symptoms should stop usage immediately. In case of low blood pressure and multi organ failure, various treatments like administration of IV gamma globulin, fluid management, dialysis and ventilation is adopted.
Toxic shock syndrome is a critical ailment and common symptoms like high fever, skin rash and infection may eventually develop into TSS. Hence, it is important not to ignore them and seek immediate medical advice.