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Toxic shock syndrome (TSS) is a rare, life-threatening condition caused by infection with certain types of bacteria, including Staphylococcus aureus, Streptococcus pyogenes, and Clostridium sordellii. The bacteria release toxins into the bloodstream, which then spreads them to various organs in the body.

Although toxic shock syndrome has been associated with the use of tampons during menstruation, this condition can also affect men, children, and people of all ages. The basic mechanisms are not fully understood, but one theory is that bacteria naturally present in the vagina can grow excessively in the presence of a blood-soaked tampon.

Toxic shock syndrome can occasionally occur as a complication after surgery or birth, worsen very quickly, and can be fatal if not treated immediately.

CAUSES OF TOXIC SHOCK SYNDROME

These things can increase the risk of developing toxic shock syndrome:

  • Bacteria: Toxic shock syndrome is caused by bacteria such as staphylococcus, streptococcus, or clostridium. These bacteria normally live on the skin, in the nose or mouth, without causing any harm, but if there are lesions in these areas, such as cuts, scratches, infections, surgical wounds or even blisters caused by chickenpox, the bacteria can penetrate through these lesions and lead to tissue damage. Most cases are related to staphylococcus bacteria.
  • Use of tampons: Experts are not sure why the use of tampons sometimes leads to this condition. It is believed that a tampon that is not changed for a long time attracts bacteria. Another option is that the tampon fibers scratch the vagina, creating an opening for bacteria to enter the bloodstream. Due to changes in the way tampons are made, the incidence of toxic shock syndrome has decreased.
  • Use of barrier contraceptive methods, such as classic diaphragm, cervical diaphragm, or vaginal sponge
  • Recent birth history, miscarriage, or abortion
  • Use of nasal swabs to treat bleeding
  • Local skin infection
  • Osteomyelitis (bone infection)

Toxic shock syndrome is not contagious, it is not transmitted from one person to another. The body does not gain immunity against toxic shock syndrome, so it can occur several times.

PREVENTION OF TOXIC SHOCK SYNDROME

The following precautions may reduce the risk of developing toxic shock syndrome:

  • Quickly treat wounds and burns and see a doctor if you notice signs of an infection, such as swelling, redness, and severe pain
  • Always use tampons with low absorption power
  • Consider using pads instead of tampons on low flow days
  • Wash your hands before and after inserting the tampon
  • Use gentle movements when inserting and removing the tampon
  • Change the tampon regularly, usually between four and eight hours
  • Once you have removed the tampon from the package, use it immediately, not later
  • Do not insert multiple tampons into the vagina at the same time
  • Avoid tampons with an applicator, as the applicator can injure the vaginal walls
  • Between menstruations, keep the tampons in a place away from heat and moisture; otherwise, the bacteria can multiply
  • During the night, use pads instead of tampons
  • Maintain proper intimate hygiene during menstruation
  • Do not use tampons outside of menstruation
  • Reduce the use of diaphragms or vaginal sponges

Note: If you have had toxic shock syndrome, you should not use tampons.

SYMPTOMS OF TOXIC SHOCK SYNDROME

The symptoms of toxic shock syndrome can vary from person to person, but they start suddenly and get worse quickly. How toxic shock syndrome affects the body depends on the type of bacteria.

Symptoms of toxic shock syndrome caused by Staphylococcus aureus:

  • Fever higher than 38.9°C (102°F)
  • Headache
  • Chills
  • Fatigue
  • General malaise
  • Flat red rashes that resemble sunburn on a large area of the body
  • Low blood pressure
  • Vomiting
  • Diarrhea
  • Muscle pain
  • Decreased production of urine and sediment in the urine
  • Decreased liver function
  • Disorientation and confusion
  • Bruising
  • Exfoliation of the palms and soles

Symptoms of toxic shock syndrome caused by Streptococcus pyogenes:

  • Very low blood pressure
  • Shock
  • Decreased kidney function
  • Bleeding
  • Bruising
  • Flat red rashes that resemble sunburn on a large area of the body
  • Liver failure
  • Exfoliation of palms and soles (occurs less frequently)
  • Difficult breathing

Symptoms of toxic shock syndrome caused by Clostridium sordellii:

  • Nausea and/or vomiting
  • Weakness
  • Flu-like symptoms
  • Sensitive abdomen
  • Swelling
  • A high number of red and white blood cells
  • Very fast heart rate
  • No fever
  • Low blood pressure

DIAGNOSIS OF TOXIC SHOCK SYNDROME

To confirm the diagnosis of toxic shock syndrome, doctors will consider physical examination and symptoms.

Other diagnostic tests will include:

  • Cultures from tissue samples on the skin, throat, nose, cervix, and vagina to identify bacteria that cause toxic shock syndrome
  • Blood tests to check liver and kidney function
  • Urine tests
  • Chest X-ray for signs of lung damage

TREATMENT FOR TOXIC SHOCK SYNDROME

Toxic shock syndrome is a medical emergency. People with this condition will be hospitalized and treated in an intensive care unit for a few days so that medical staff can monitor them closely. Rapid treatment can prevent major organ damage.

Treatment for toxic shock syndrome may involve:

  • Administration of intravenous antibiotics to treat the infection
  • Administration of intravenous fluids to prevent dehydration and organ damage
  • Dialysis if the kidneys stop working
  • Cardiac medicines for people with very low blood pressure
  • Gamma globulin injections to reduce inflammation and stimulate the immune system
  • In severe cases, surgery may be needed to remove the affected tissue
  • Mechanical ventilation

If you want to find out about the reasons for delayed menstruation, check out our article on this topic: 16 reasons for delayed or stopped menstruation.

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