Toxic shock syndrome (patient information)

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 * Assistant Editor(s)-in-Chief: Meagan E. Doherty

Overview
Toxic shock syndrome is a severe bacterial infection that involves fever, shock, and problems with the function of several body organs.

Toxic shock syndrome is caused by a toxin produced by certain types of Staphylococcus bacteria. A similar syndrome, called toxic shock-like syndrome (TSLS), can be caused by Streptococcal bacteria.

Although the earliest described cases of toxic shock syndrome involved women who were using tampons during their periods (menstruation), just slightly over half of current cases are associated with such events. Toxic shock syndrome can also occur in children, postmenopausal women, and men.

What are the symptoms of Toxic shock syndrome?

 * Confusion
 * Diarrhea
 * General ill-feeling
 * Headaches
 * High fever, sometimes accompanied by chills
 * Low blood pressure
 * Muscle aches
 * Nausea and vomiting
 * Organ failure (usually kidneys and liver)
 * Redness of eyes, mouth, throat
 * Seizures
 * Widespread red rash that looks like a sunburn -- skin peeling occurs 1 or 2 weeks after the rash, particularly on the palms of the hand or bottom of the feet

Who is at highest risk?
Risk factors include:
 * Childbirth
 * Current Staphylococcus aureus (S. aureus) infection
 * Foreign bodies or packings (such as those used to stop nosebleeds)
 * Menstruation
 * Surgery
 * Tampon use (particularly if you leave on in for a long time)
 * Use of barrier contraceptives such as a diaphragm or vaginal sponge

Diagnosis
No single test can diagnose toxic shock syndrome. The diagnosis is based on several criteria: fever, low blood pressure, a rash that peels after 1-2 weeks, and problems with the function of at least three organs. In some cases, blood cultures may be positive for growth of S. aureus.

When to seek urgent medical care
Toxic shock syndrome is a medical emergency. You must seek immediate attention if you develop fever or rash, particularly during menstruation and tampon use, or if you have had recent surgery.

Treatment options
Any foreign materials, such as tampons, vaginal sponges, or nasal packing, will be removed. Sites of infection (such as a surgical wound) will be drained.

The goal of treatment is to maintain important body functions. This may include:
 * Antibiotics for any infection (may be given through an IV)
 * Dialysis (if severe kidney problems are present)
 * Fluids through a vein (IV)
 * Methods to control blood pressure

Where to find medical care for Toxic shock syndrome?
Directions to Hospitals Treating Toxic shock syndrome

What to expect (Outlook/Prognosis)?
Toxic shock syndrome may be deadly in up to 50% of cases. The condition may return in those that survive.

Possible complications

 * Severe organ dysfunction:
 * Kidney failure
 * Heart failure
 * Liver failure


 * Shock

Diseases with similar symptoms

 * Toxic shock-like syndrome
 * Gram-negative sepsis
 * Scarlet fever
 * Viral exanthem
 * Rickettsial disease
 * Kawasaki disease
 * Staphylococcal scalded skin syndrome
 * Exfoliative erythroderma syndrome
 * Erythema multiforme major
 * Drug eruption

Prevention of Toxic shock syndrome
Menstrual toxic shock syndrome can be prevented by avoiding the use of highly absorbent tampons. You can reduce your risk by changing tampons more frequently and using tampons only once in a while (not regularly) during menstruation.