Toxic shock syndrome (TSS) is a rare but life-threatening condition that can occur suddenly as a severe complication of a bacterial infection. The main causative factor for toxic shock syndrome is Staphylococcus or Group A streptococcus (strep) bacterium. The bacteria get into the bloodstream and release their toxins.
It can affect anyone, but menstruating women are more prone to developing toxic shock syndrome as the super-absorbent tampons or pads are also a causative factor. TSS is a medical emergency condition. All of us should know its signs and symptoms and how to prevent them.
Signs and symptoms of toxic shock syndrome
The toxic shock syndrome is an acute onset condition that occurs when the bacterium reaches into the blood and produces toxicants. The signs and symptoms of TSS differ for every individual. TSS is a group of numerous symptoms involving different systems of the body. The following are some common signs and symptoms are:
- Sudden onset of high-grade fever (more than 102°f or 38.9°c)
- Headache and muscle aches
- A sudden decrease in blood pressure is associated with lightheadedness or sometimes fainting.
- Red and flat rashes similar to sunburn covering the entire body, including but not limited to the palms of the hands and soles of the feet
- Diarrhea and abdominal pain
- Decrease in urine output
- The mouth, eyes, vagina, and area around the wound appear redder due to increased blood flow
TSS can affect the other organs’ functions, such as:
- Decrease kidney functions that cause lower urine production and waste discharge from urine
- Confusion and disorientation
- Diminished liver functions
- Unexplained bruising due to low blood platelet counts
- Excessive bleeding
- Shedding of the larger skin area rarely, especially over the palms and soles of the foot
The causes of toxic shock syndrome
When some bacteria invade the bloodstream and release toxins, a person experiences this syndrome. The following bacteria commonly cause toxic shock syndrome:
- Staphylococcus aureus: S. aureus is a normal resident of our body. They can cause sinusitis, pneumonia, osteomyelitis, or wound infections (burn or surgical incisions). If any of these conditions get infected, the bacteria may enter the bloodstream and causes TSS.
- Streptococcus pyogenes: Strep may cause TSS as a secondary infection in people who recently had bacterial cellulitis, chickenpox, or weaker immunity.
- Clostridium sordellii: C. sordellii bacteria are common inhabitants in the vagina and are harmless. But, when these bacteria enter the uterus during normal menstruation, baby delivery, or invasive gynecological procedures such as abortion, they may cause toxic shock syndrome.
What are the risk factors for TSS?
TSS may occur due to bacterial invasion in our circulatory system. The bacteria can enter our blood in various ways, such as:
- Infected surgical wound
- History of using super-absorbent tampons
- An infection in the skin or underlying deep tissues
- Recently using of birth control methods, such as contraceptive sponges and diaphragm
- Recent childbirth, abortion, or miscarriage
- Recent history of chickenpox, abscess, or pneumonia
Diagnosis of toxic shock syndrome
If the doctors suspect TSS, they immediately start intravenous fluid and medications before confirming the condition. To determine the TSS, the healthcare provider suggests the following investigations:
- Blood cultures to rule out causative organism
- A complete blood profile: These tests measure bleeding and clotting time, blood cells count, and liver and kidney functions.
- Sample from the infectious site, such as skin, nose, mouth, and vagina
- Urine test to detect pathogen and sediments presence
- Lumbar puncture to detect the bacteria in spinal fluid
Treatment of toxic shock syndrome
The following are the treatment regimens for TSS:
- Administration of intravenous (IV) fluid to treat shock and prevent organ damage
- Intravenous antibiotics
- Management of low blood pressure levels
- Additional oxygen or mechanical ventilation to ease breathing
- Cleaning of the infected wound
- Removal of contraceptive devices, tampons, or wound packing
- Drainage of abscess and fluid build-ups
- Dialysis in patients who develop kidney failure
TSS needs immediate medical attention and treatment; otherwise, it can result in amputation, severe organ damage, or even death.
Prevention of TSS
TSS may appear similar to other infections, but the condition deteriorates rapidly and may endanger life. Therefore the best way is to adopt preventive measures to avoid it. The preventive measures include:
- Washing hands before and after treating a wound and cleaning them frequently
- During menstruation, wash hands before and after inserting a tampon or alternating them with sanitary pads.
- Change the tampons and pads often to avoid infection
- Any female who previously had TSS should avoid tampons, as they can insert the bacteria deep into the uterus.
TSS can appear suddenly and worsen within a blink of an eye. So, immediately connect to the healthcare provider if you or your family member get a sudden fever, vomiting, sudden fainting, and other symptoms of TSS. If detected early, the prognosis of TSS is best.