What Is Toxic Shock Syndrome (TSS)?
Toxic shock syndrome is a rare but serious medical condition caused by a bacterial infection. It is caused when the bacterium Staphylococcus aureus gets into the bloodstream and produces toxins. Although toxic shock syndrome has been linked to superabsorbent tampon use in menstruating women, this condition can affect men, children, and people of all ages.
Causes
The cause of toxic shock syndrome (TSS) is one of several closely related exotoxins secreted by bacteria that are infecting the person. The toxins activate T cells of the immune system to produce chemicals known as cytokines that subsequently cause shock and tissue damage. Although there are several closely related exotoxins, about 80% of individuals with TSS have an illness caused by TSST-1 or a similar exotoxin. M protein, a filamentous protein on the cell membrane of group A Streptococcus bacteria enhances the likelihood of the bacterial strain being more likely to cause disease. Bacterial strains that lack M protein are less lethal because M protein can protect bacteria from host immune defenses. Moreover, M protein apparently enhances cell damage and inflammation caused by exotoxins.
Symptoms
Symptoms of toxic shock syndrome can vary from person to person. In most cases, symptoms appear suddenly. Common signs of this condition include:
Who is at risk for toxic shock syndrome?
The following are risk factors for toxic syndrome:
- History of using super-absorbent tampons
- Surgical wounds
- A local infection in the skin or deep tissue
- History of using the diaphragm or contraceptive sponge
Diagnosis
Your doctor may make a diagnosis of toxic shock syndrome based on a physical examination and your symptoms. Additionally, your doctor may check your blood and urine for traces of Staphylococcus or Streptococcus bacteria. Your doctor may also do a blood test to check your liver and kidney function. They may also take swabs of cells from your cervix, vagina, and throat. These samples are analyzed for the bacteria that cause toxic shock syndrome.
Treatment
The treatment for TSS greatly varies from patient to patient; however, the following treatments are fairly common. Patients with TSS usually will be treated with two or more of the following treatments:
- Intravenous fluids to treat shock
- IV antibiotics
- Deep surgical cleaning of any infected wounds
- Cardiac medications to help treat low blood pressure
- Oxygen and/or mechanical ventilation as needed
- Hospitalization in an intensive-care unit
Patients with TSS who are diagnosed early and given appropriate treatment often have a rather good prognosis. Early treatment can help prevent risky complications such as renal failure, respiratory failure, and coagulation disorders. However, the death rate is about 5%-15%, and patients who develop complications have a poorer prognosis than those who do not. Patients who develop TSS are at risk for reinfection. Toxic shock syndrome is a medical emergency that can cause death if left untreated. Call an ambulance or go to the emergency room if you suspect that you have symptoms of toxic shock syndrome. Prompt treatment can prevent major organ damage.
