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TSS is a rare but serious condition caused by bacterial infections which can develop quickly, lead to fever, rash, and organ failure.

 

What is Toxic Shock Syndrome?

 

Toxic Shock Syndrome is a rare but life-threatening complication of certain types of bacterial infections. Toxic Shock Syndrome usually comes from toxins made by Staphylococcus aureus (Staph) bacteria, but it may also result from toxins caused by group A streptococcus (Strep) bacteria. 

 

Contrary to popular belief, Toxic Shock Syndrome does not only affect people who menstruate. Toxic Shock Syndrome can affect people who don’t have periods and children. According to Healthline, the average cases are 1 in 4 per 1000 in the US. Indeed, people between who have periods between ages 15 to 25 who use tampons have a higher risk. There are things to consider, which we’ll go over in this article.

 

Causes Of Shock Syndrome

 

Firstly, what are some causes of Shock Syndrome?

 

While Toxic Shock is usually caused by Staphylococcus aureus, it’s not the only cause, Streptococcus pyogenes (GAS) is another cause of Toxic Shock Syndrome. GAS can also be called streptococcal toxic shock syndrome or toxic shock-like syndrome (TSLS). This condition occurs when GAS enters via any skin injury (burns, cuts, recent surgery, etc.) or bacteria in the throat, then spreads through deep tissues and the bloodstream over time. 

 

You may think, ‘What does this have to do with tampons?’. The link between Toxic Shock Syndrome and tampons isn’t exactly clear but experts believe when you leave a tampon in for long periods, it attracts bacteria as the tampon is soaked with blood and becomes an ideal place for bacteria to grow. Furthermore, the material of the tampon is an important consideration as that could be another cause of Toxic Shock Syndrome.  The material of the tampon scratches the vagina and thus makes an entrance for those bacteria. 

 

Other products that may result in Toxic Shock Syndrome are menstrual sponges, diaphragms, and cervical caps, especially devices that have been in the vagina for a long time – more than 30 hours. In the case of sponges alone, pieces of the sponge may remain in the vagina. When these products are not put in carefully, they can cause micro-tears that can lead to bacteria growth and subsequently, Toxic Shock Syndrome. 

 

Prevention for Toxic Shock Syndromes

 

Some ways we can prevent Toxic Shock Syndrome:

  • Wash your hands thoroughly before inserting a tampon
  • Use the lowest absorbency tampons for your period flow
  • Change tampons regularly as directed on the package 
  • Avoid using more than one tampon
  • Insert a fresh tampon when going to bed and replace it immediately in the morning
  • Remove the tampon as soon as menstruation has ended
  • Switch from tampons to sanitary towels or panty liners at times during your period
  • Use mini pads instead of tampons if the flow is light
  • If you get a wound, keep it clean, dry, and bandaged. Make sure to change your bandages regularly.
  • Any time you see signs of infection in a wound — redness, swelling, pain, fever — tell your doctor as soon as possible so it can be treated.
  • Use a reusable, silicone menstrual cup and clean your hands thoroughly when changing it
  • If you have open wounds, avoid spending time in hot tubs, swimming pools or any natural source of water 
  • Practice good hygiene 

Risk Factors

 

People who are more at risk include those who experienced or have:

  • Recent childbirth
  • Use of a diaphragm or vaginal sponge to prevent pregnancy
  • An open skin wound
  • Use of superabsorbent tampons
  • Nasal packing
  • Compromised immune system
  • Recent flu diagnosis
  • Over 65 
  • People with diabetes or alcohol use disorder
  • Chickenpox
  • Undergone surgery 

Symptoms of Toxic Shock Syndrome  

 

Some symptoms of Toxic Shock Syndrome include the following:

  • A high fever that spikes suddenly
  • Low blood pressure
  • Throwing up or frequent, watery stools
  • A rash that looks like a sunburn, especially on your palms and the bottoms of your feet
  • Confusion (described as a foggy brain)
  • Muscle aches
  • Red eyes, mouth, and throat
  • Headaches
  • Diarrhea
  • Feeling faint
  • Dizziness
  • Sore throat or problem swallowing

 

Severe symptoms appear after blood pressure drops and failure to get to proper medical aid include:

  • Coagulopathy, which presents with signs such as bruising, easy or prolonged bleeding, pinpoint rash, blood in urine or stool, or bleeding from the gums
  • Fainting spells
  • Amputation of limbs 
  • Organ failure
  • Seizures
  • Hypotension (low blood pressure)
  • Tachycardia (faster than normal heart rate)
  • Tachypnea (rapid breathing)
  • Death 

 

When to See a Doctor?

 

See a doctor when you start realizing symptoms of what you’re experiencing correspond with symptoms of Toxic Shock Syndrome. It’s important to consult a doctor or be diagnosed as soon as possible as Toxic Shock Syndrome is a rapid disease that spreads through the body and can result in permanent damage or death if caught too late. 

 

Go to your doctor or the nearest hospital emergency room as soon as you can. 

What to Expect When Getting Diagnosed?

 

When getting diagnosed, you can expect the following. It is important to note that your results can take up to three days which is why it is important to get checked as soon as possible. 

 

Doctors will look at the following:

 

  • Blood test 
  • Urine test
  • A temperature above 39 to 40.5 degrees Celsius or 102.02 degrees Fahrenheit
  • Dangerously low blood pressure
  • A skin rash
  • Evidence that at least three organs have been affected by the infection
  • MRI test for damaged tissue
  • CT scan for damaged tissues
  • A CBC (complete blood count) testing for white blood cell count or a decrease in platelets
  • Taking swabs of cells from the cervix, vagina, and throat
  • Analyzing samples for bacteria that cause TSS
  • A coagulation study to evaluate blood clotting ability

 

Treatment

 

Treatment in severe cases occurs at a hospital which may include the following:

  • Oxygen: The patient will usually be given oxygen to support breathing
  • Fluids: These can prevent dehydration and bring blood pressure back up to normal
  • Kidneys: A dialysis machine can treat kidney failure by filtering toxins and waste out of the bloodstream
  • Damage to skin, fingers, or toes: Treatment may include draining and cleaning wounds in these locations, and, in severe cases, amputation
  • Antibiotics: They can be given by IV, directly into the bloodstream
  • Immunoglobulin: Samples of donated human blood with high levels of antibodies can be administered to fight the toxin, sometimes alongside antibiotics
  • Medication to stabilize blood pressure
  • If a vaginal sponge or tampon triggered toxic shock, your doctor may need to remove this foreign object from your body.
  • If an open or surgical wound causes TSS, the doctor will drain pus or blood from the wound to clear any infection.

 

Remember that 3 out of 10 people who are diagnosed with Toxic Shock Syndrome die from Toxic Shock Syndrome which is the main reason to get diagnosed as soon as possible.

 

Conclusion 

 

Toxic Shock Syndrome is something to be wary of as it’s a deadly viral infection that can be fatal, as well as who it is at risk. It is important to know the prevention methods to minimize the risk of Toxic Shock Syndrome as well as the symptoms, tests, and treatments that someone with Toxic Shock Syndrome may experience.

 

Summary

 

Toxic Shock Syndrome is a viral disease that does not only happen to individuals with periods but also those without periods and children. 1 in 4 people per 1000 in the US will experience Toxic Shock Syndrome.  It’s important to realize Toxic Shock Syndrome can have serious health consequences if you’re unable to seek help in time. For instance, some consequences include organ failure, amputation, seizures, and even death. The biggest risk factors include recent childbirth, use of a diaphragm or vaginal sponge to prevent pregnancy, an open skin wound, use of superabsorbent tampons, nasal packing, compromised immune system, recent flu diagnosis, being over the age of 65, people with diabetes or alcohol use disorder, and undergoing surgery. Some of the symptoms to look out for include a high fever that spikes suddenly, low blood pressure, throwing up or frequent, watery stools, a rash that looks like a sunburn, especially on your palms and bottoms of your feet, confusion (described as a foggy brain), muscle aches, red eyes, mouth, and throat, headaches, vomiting, diarrhea, feeling faint, dizziness, sore throat or problem swallowing. In severe cases, symptoms involve coagulopathy, which presents with signs such as bruising, easy or prolonged bleeding, pinpoint rash, blood in urine or stool, or bleeding from the gums, fainting spells, hypotension (low blood pressure), tachycardia (faster than normal heart rate) or tachypnea (rapid breathing). 

 

When you first see these symptoms, you need to go to the hospital’s emergency room or your doctor as soon as possible because it can take up to three days to be diagnosed. Getting diagnosed includes a blood test, urine test, a temperature above 39 to 40.5 degrees Celsius or 102.02 degrees Fahrenheit, dangerously low blood pressure, a skin rash, evidence that at least three organs have been affected by the infection, MRI or CT scan test for damaged tissue, a CBC (complete blood count) testing for white blood cell count or a decrease in platelets, taking swabs of cells from the cervix, vagina, and throat, analyzing samples for bacteria that cause TSS, a coagulation study to evaluate blood clotting ability. Treatment includes antibiotics, fluids for your body, amputation of limbs in severe cases, samples of other people’s blood that have the antibodies to fight Toxic Shock Syndrome, medication to stabilize blood, the removal of a menstrual product or care for a wound. Treatment may also include support for failing organs. As you can see from the symptoms, diagnosis and treatment options Toxic Shock Syndrome is something to take seriously. 3 in 10 people will die due to not receiving help in time. In conclusion, take Toxic Syndrome seriously, look for the signs, and try your best to minimize the risk. 

 

Works Cited

better health channel. “Toxic Shock Syndrome (TSS).” Vic.gov.au, 2012, www.betterhealth.vic.gov.au/health/conditionsandtreatments/toxic-shock-syndrome-tss.

CDC. “Necrotizing Fasciitis.” Centers for Disease Control and Prevention, 19 July 2020, www.cdc.gov/groupastrep/diseases-public/streptococcal-toxic-shock-syndrome.html.

https://www.facebook.com/WebMD. “Understanding Toxic Shock Syndrome — the Basics.” WebMD, WebMD, Nov. 2001, www.webmd.com/women/guide/understanding-toxic-shock-syndrome-basics.

Mayo Clinic Staff. “Toxic Shock Syndrome – Symptoms and Causes.” Mayo Clinic, 2017, www.mayoclinic.org/diseases-conditions/toxic-shock-syndrome/symptoms-causes/syc-20355384.

Ross, Adam, and Hugh W Shoff. “Toxic Shock Syndrome.” Nih.gov, StatPearls Publishing, 22 June 2019, www.ncbi.nlm.nih.gov/books/NBK459345/.

Services, Department of Health & Human. “Toxic Shock Syndrome (TSS).” Www.betterhealth.vic.gov.au, www.betterhealth.vic.gov.au/health/conditionsandtreatments/toxic-shock-syndrome-tss#where-to-get-help. Accessed 28 Dec. 2022.

Todd, J K. “Toxic Shock Syndrome.” Clinical Microbiology Reviews, vol. 1, no. 4, Oct. 1988, pp. 432–446, 10.1128/cmr.1.4.432.

“Toxic Shock Syndrome: Background, Pathophysiology, Etiology.” Medscape.com, 9 Nov. 2019, emedicine.medscape.com/article/169177-overview.

“Toxic Shock Syndrome: Symptoms, Diagnosis, and Treatment.” Healthline, 17 Sept. 2018, www.healthline.com/health/toxic-shock-syndrome#treatment.