Toxic Shock Syndrome - Causes, Symptoms, Diagnosis, Complications, and Treatment

What Is Toxic Shock Syndrome?

Toxic shock syndrome, otherwise called TSS, is a rare and potentially fatal complication of some types of bacterial infection. This infection usually starts with a strain of staphylococcus or streptococcus bacteria. People of any age and gender can be affected by this condition, but it is more common in women in the reproductive age group. In the 1980s, several healthy women died mysteriously due to sudden fever, shock, and multiple organ failure. Only after this was TSS noted as a health hazard for women in their reproductive years. In the United States, TSS affected 6 of 100,000 women every year during the 1980s. But after 1986, due to the removal of super-absorbent tampons from the market, the number went down to one in every 100,000. Complications of skin injury or surgery can result in TSS in men, children, and menopausal women.

What Are the Types of Toxic Shock Syndrome?

The types of TSS are:

• Staphylococcal TSS - It is caused by the bacteria Staphylococcus aureus.

• Streptococcal TSS - It is caused by group A Streptococcus bacteria.

What Are the Warning Signs of Toxic Shock Syndrome?

The signs and symptoms of TSS suddenly develop and worsen quickly, indicating that the person’s body is full of toxins.

The warning signs of TSS that appear in a few hours are:

• High fever.

• Vomiting.

• Headaches.

• Diarrhea.

• Rashes that look like sunburn on palms and soles.

• Dizziness.

• Muscle pain.

• Loss of consciousness.

• Confusion.

• Low blood pressure (hypotension).

• Seizures.

If left untreated, this condition can progress rapidly and can be fatal in less than 48 hours, as it leads to kidney failure, shock, and multiple organ failure. So if one is regularly using tampons, recently underwent surgery, or suffered a skin injury or infection and experiences these symptoms, then go to the emergency room immediately. The tampon should be immediately removed.

What Causes Toxic Shock Syndrome?

Infection with Streptococcus or Staphylococcus bacteria can result in toxic shock syndrome. The factors that increase the risk of these infections are:

• Using super-absorbent tampons.

• Soft-tissue injuries.

• Burn injury.

• A localized infection is like a boil.

• Use of a contraceptive sponge.

• Infected wounds.

• Childbirth.

• Viral infections, such as chickenpox and flu.

About 20 to 30 percent of humans carry these bacteria in their skin and nose without side effects. When people do not have the necessary antibodies to fight off these bacteria, they only result in infections. Super-absorbent tampons are believed to be kept inside the body for a prolonged period and become the perfect environment for bacteria to grow.

The fibers used in these tampons scratch the vaginal walls, which form the way for bacteria to enter the body. Similarly, bacteria can enter the bloodstream through cuts, burns, and local infections.

The bacteria release toxins in the bloodstream, which spread to other organs. This results in low blood pressure, which leads to shock and symptoms like confusion and loss of consciousness. As these toxins spread, they shut down the functioning of various organs in the body, resulting in multiple organ failure.

How Is Toxic Shock Syndrome Diagnosed?

TSS is rare, so the doctor needs to identify the symptoms and treat them promptly, as the disease progresses rapidly and can be fatal. The symptoms to look out for are:

• Fever is more than 39 to 40.5 degrees Celsius or 102.02 Fahrenheit.

• Very low blood pressure.

• Skin rashes.

• Results suggest that a minimum of three organs have been affected.

The following tests for toxic shock syndrome might be necessary:

• Blood tests and urinalysis-To check organ function or organ failure and detect staph or strep infection.

• Samples taken from any lesion, nose, or vagina are sent for investigation to check for infection.

• CT scan (computed tomography), MRI (magnetic resonance imaging), or chest X-ray - to detect tissue damage.

• Lumbar puncture - to check how much the disease has progressed.

How Is Toxic Shock Syndrome Treated?

If one has been diagnosed with toxic shock syndrome, then they will be treated in the hospital. The first-line treatment for toxic shock syndrome includes antibiotics such as Clindamycin, Vancomycin, Oxacillin, Nafcillin, or Linzolid.

The treatment process includes:

• Administering antibiotics intravenously, and the source of infection is identified.

• Medicines are given to bring the blood pressure back to normal.

• Fluids are given to prevent dehydration.

• Symptomatic treatment is given for any other signs or symptoms.

• If the kidneys are not functioning properly, then dialysis might be needed.

• Surgery removes dead or necrosed tissue from the site of infection or drains an abscess.

What Are the Possible Complications of Toxic Shock Syndrome?

TSS can lead to life-threatening complications, as it results in multiple organ failure, shock, and death. This condition has to be promptly treated to prevent complications.

The possible complications include:

• Liver Failure - The symptoms of liver failure include jaundice (yellowing of the skin and eyes), abdominal pain, problems concentrating, nausea, vomiting, and confusion.

• Heart Failure - The symptoms include palpitations, chest pain, cough, wheezing, loss of appetite, poor concentration, tiredness, weakness, and dyspnea (shortness of breath).

• Kidney Failure - Fatigue, nausea and vomiting, hiccups, muscle cramps, itching, chest pain, dyspnea, hypertension (high blood pressure), swollen feet and ankles, and urination problems are some of the common symptoms of kidney failure.

• Shock - Low blood flow through the body.

What Are the Preventive Measures for Toxic Shock Syndrome?

The following measures can reduce the risk of developing toxic shock syndrome:

• Make sure to change the tampon every four to eight hours.

• Always use low-absorbency tampons or sanitary pads during periods.

• If using a menstrual cup, one should go for a reusable silicone menstrual cup.

• Clean the hands properly while changing the menstrual cup.

• When the menstrual flow is light, use a sanitary pad instead of a tampon.

• Frequently wash the hands thoroughly.

• Keep the surgical incisions clean and dry if a person undergoes any surgery.

• Consult the doctor regularly to change the surgical dressing.

• Avoid using tampons if one has suffered from toxic shock syndrome in the past.

Conclusion

Therefore, it is crucial to diagnose and treat toxic shock syndrome immediately to prevent permanent organ damage or death. If one feels they are exhibiting symptoms of TSS, then they must seek emergency medical help immediately. They must consult the doctor and ensure regular follow-ups for detailed assessment, monitoring, and assistance.