Dorothy FarrarToxic shock syndrome
Toxic shock syndrome (TSS) mainly affects women who use tampons during menstruation. The disease is very rare, but severe and can be fatal. With thorough hygiene, infection can be easily avoided.
What is toxic shock syndrome?
Toxic shock syndrome is a bacterial infection that leads to severe failure of circulation and organs. Without treatment, the disease is fatal. The syndrome occurs very rarely and is diagnosed annually in 0.5 out of 100,000 inhabitants. TSS was first described in the late 1970s in the United States in young girls who used highly absorbent tampons during menstruation. Due to inadequate hygiene and excessive wearing time, they became infected with staphylococci via the vagina.
Causes
The bacteria produce the poison Toxic-Shock-Syndrome-Toxin-1 (TSST-1). This acts as a superantigen and activates an excessive immune response. The antibodies formed also attack the body’s own cells in a non-specific manner and thus trigger the shock. Less frequently than staphylococci, certain bacterial forms of streptococci or clostridia are responsible for TSS. These produce similarly acting toxins.
In more than half of all cases, the occurrence of the disease can be attributed to the inadequate use of tampons and diaphragms. Hence the common term “tampon disease”. If the users do not use appropriate applicators during insertion, there is a risk that the bacteria will be introduced through the skin of the fingers. In addition, too long a wearing period favors the toxin production of the staphylococci in the vagina and uterus: The magnesium-poor environment of the vagina is deprived of additional magnesium by the tampon.
In such an environment, the bacteria can produce the poison faster. However, the disease can also be caused by the penetration of the bacteria through the respiratory tract or wounds in the skin (cuts, burns, surgical wounds, insect bites, bursitis).
Symptoms and course
Typical symptoms of toxic shock syndrome:
Toxic shock syndrome breaks out in full health without sign. In the first 48 hours, an even, sunburn-like rash develops on the skin. In particular, the soles of the feet and palms are affected, but also shoulders and, in a weaker form, the face. The acute phase is characterized by high fever above 39°C, dizziness, nausea, vomiting, diarrhoea and chills.
Furthermore, the blood pressure drops and it comes to headache and local muscle pain as well as tachycardia. From the vagina, purulent discharge comes out, and the mucous membranes are reddened. The enormous strain on the body can also lead to circulatory collapse. The disorders of multiple organ systems are critical – if TSS is not treated or complications occur, multiple organ failure can lead to death.
Mortality in the first three weeks is between three and five percent (other figures say between two and eleven percent). In addition, an underactive liver and kidneys can develop. If therapy is successful, skin cells detach during the recovery phase (scaling). After healing, the loss of nails and hair can also occur.
Diagnosis
TSS is diagnosed based on the symptoms that occur. In addition to fever, low blood pressure and the rashes, muscle pain and the reddened mucous membranes in the vagina and mouth indicate the disease. Observable disturbances of the organ systems are also crucial. Here, according to the complaints mentioned, the digestive system, the nervous system as well as the liver and kidneys are affected.
The bacteria can be detected by swabs on vaginal or other mucous membranes. It is also possible to detect toxin antibodies in the blood. The doctor should be informed in detail by the patient about her cycle and her use of tampons.
Treatment and therapy
Treatment is carried out in the hospital and, due to the severe symptoms, in many cases in the intensive care unit. The infection is eliminated by fighting the bacteria with antibiotics and antibodies. In this case, possible resistances of the pathogens should be excluded in advance with an antibiogram. In addition, local treatment in the vagina is recommended. For successful recovery, in addition to fighting the infection, an accompanying stabilization of the circulation and the disturbed organ systems is necessary: The shock results from an undersupply of oxygen to the tissue, which can be avoided by oxygen supply and possible ventilation.
The fluid loss that occurs through sweating and increased kidney activity is compensated for by intravenous fluids . In addition, the ph of the blood should be normalized. Medicines can be given to reduce fever, calm down, and relieve pain . If the syndrome is treated early, the prognosis for treatment is good. Mortality is between three and five percent in the first three weeks (in the case of non-menstrual infection between two and eleven percent). If the disease is not treated, the mortality rate is 50 percent.
Prevention
In order to avoid infection, thorough hygiene must be ensured during the menstrual period. The tampons should be inserted with clean hands or appropriate applicators. The users should change the tampons regularly every four to eight hours and alternatively use pads. Tampons made from organic cotton and reusable menstrual cups reduce the risk of infection. If symptoms occur, the doctor should be contacted immediately.
Hello and welcome to my Health Guide & Encyclopedia! My name is Dorothy Farrar, and I'm the founder and main author of this platform.
My passion for health and wellness started at a young age when I became interested in the connection between the food we eat and the way we feel. This fascination led me to study nutrition and dietetics in college, where I learned about the importance of a balanced diet and the impact of various nutrients on the body.