Know your risk for toxic shock syndrome (TSS)

You probably heard about toxic shock syndrome when you first got your period, or started using tampons. The ‘you know what happens when…’ stories were probably enough to scare you into reading the information pamphlet in every box of tampons, but have you thought about it since? The dangers of TSS are still very real and it can happen to anyone.
Toxic shock syndrome is a rare, sudden illness that affects men, women and children of all ages. It can happen suddenly following an infection and can quickly become life threatening. There are two main infection-causing bacteria that can lead to TSS – strep and staph. Both are common and usually harmless, but they create toxins which can cause a severe immune reaction when they enter the bloodstream. Strep toxic shock syndrome most often occurs after childbirth with the flu chickenpox, surgery, minor skin cuts or wounds, and even injuries that bruise but may not break the skin. Staph toxic shock syndrome is most common after a tampon is kept in too long (menstrual TSS) or after surgery.

Cases of menstrual TSS are declining thanks to increased awareness of the direct relationship of TSS and tampon use. Also, some of the more absorbent kinds of tampons are no longer available, so tampons must be changed more often and this decreases the risk of TSS. But while instances of menstrual TSS have decreased, forms of non-menstrual TSS continue to occur at a steady rate.

Signs and Symptoms of Toxic Shock Syndrome (TSS)

Most people who get TSS are in good health before they show signs of illness. TSS gets worse quickly and the sudden, severe symptoms require immediate medical help. Signs of toxic shock syndrome are –

· Sudden fever over 102°F
· Signs of shock – low blood pressure, rapid heartbeat, nausea, vomiting, fainting, feeling lightheaded, restless, or confused
· A rash – looks similar to sunburn, can be in several places or just in certain places like the armpits or groin
· Severe pain in an infected cut, wound, or injury
· Severe flu-like symptoms – muscle aches and pains, stomach cramps, headache, sore throat
· Redness inside the mouth and nose
· Pinkeye
· Scaly, peeling skin – particularly on the palms of the hands and soles of the feet

Toxic shock syndrome is usually diagnosed and treated quickly. Your doctor will run tests to see whether staph or strep bacteria caused the infection. These include tests of the blood, body fluid or tissues, chest x-ray, as well as tests to rule out other infections. Because of the risk of TSS, patients are almost always treated in a hospital. Treatment includes removing the source of the infection or cleaning the wound, treating complications like shock or organ failure, and antibiotics. If treatment is received immediately and there are no major complications, a patient with TSS will recover in one to two weeks.

You can help prevent TSS – here are a few suggestions to keep you and your family healthy. If you have recently given birth, avoid using tampons and barrier birth control (such as diaphragms, cervical caps, or sponges) during the first 12 weeks after childbirth. Always follow the directions for tampons, diaphragms, or contraceptive sponges (it wouldn’t hurt to refresh your memory – read them again). You should change your tampon at least every 8 hours or limit tampon use to part of the day. Do not leave your diaphragm or contraceptive sponge in for more than 12 to 18 hours. Immediately clean and keep clean any skin wounds to avoid infection. If you have had menstrual TSS, do not use tampons, barrier contraceptives, or an intrauterine contraceptive device (IUD). While these devices are normally very safe, they can raise your risk for future infection if you have had TSS in the past.

Toxic shock syndrome is rare but serious. It can happen suddenly after an infection and can quickly harm organs including the lungs, liver and kidneys. In just two days, it can become life threatening. Strep TSS has a 40% to 50% death rate, it is more difficult to identify before serious complications start, like a blood infection (sepsis) or a rare rare bacterial infection that destroys skin. Staph TSS is also a medical emergency but only leads to death in 5% of patients when it is identified and treated properly.
This is serious business so talk to Dr. Hessel and her staff about your risk factors and the preventative measures you can take to keep toxic shock syndrome away from you and your family. Make an appointment with Dr. Hessel today – knowledge is your best protection.