Have you ever heard of toxic shock syndrome before? Hardly a few people especially those with medical background understand this rare but fatal syndrome. This is most common in females who use tampons during menstruation. However, it is not limited to women as it is caused by bacteria that can target anybody irrespective of the gender. We spoke to Dr. Gaurav Seth, Associate Consultant, Rheumatology in Aakash Healthcare Super Speciality Hospital, Dwarka who discussed in detail about this life-threatening disease. This is a deadly disease but also curable. Read this article to know everything related to this rare syndrome.
What Is Toxic Shock Syndrome?
In Dr. Gaurav Seth's words, “Toxic shock syndrome is a disease caused by bacteria and most common bacteria is Staphylococcus and streptococcus. These bacteria have some antigens known as superantigens, which hyperactivates the immune system of the infected person which leads to hypotension and other symptoms of shock. These include hypertension, fever, skin rash, fluctuations in BP, fits, epilepsy. Due to low BP caused in this condition, the patient may even suffer kidney failure, lung failure and multi-organ failure, in the worst case.”
Although TSS is linked with the use of tampons in menstruating women, the risk of getting this infection is in men and children too but comparatively lower than women. This lethal disease can lead to the patient’s death if not treated properly and on time. The treatment method and recovery depend on how severe the case is since this disease targets multiple systems at once.
As per a report published in NCBI, researchers reviewed the medical records of around 25 women aged between 13 and 41 years. These women were diagnosed with medical conditions in harmony with toxic shock syndrome or TSS. Out of 25, 14 women were diagnosed with TSS whereas 11 women had a probability of getting TSS. In all of the cases, the initial symptoms of TSS appeared in association with tampon use during periods and menstrual bleeding. All the patients got a fever where 20 women got hypotension, five women stayed normative, 20 patients got erythematous rash and two cases suffered desquamation.
Out of these 25 patients, 13 women had a recurrence of this deadly syndrome. In a lot of the cases, severe complications such as acute kidney failure, respiratory issues, coma, also occurred putting the life of the patient at risk. A whole spectrum of complications is linked with toxic shock syndrome.
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How Is Toxic Shock Syndrome Caused?
The most common cause of toxic shock syndrome is skin infection. Lately, women who used tampons were most affected by this syndrome where their body reacted to these bacteria where the patient went into shock and in most of the cases, died. The mortality rate is very high in the patients of TSS.
However, the prime cause of this syndrome is the bacteria that enters the body through a skin infection, injury, cut or wound. Long use of tampons also causes the buildup of this bacteria in the vaginal part of a menstruating woman. This is highly common with teenage girls who just started menstruating as their body is sensitive at this time which makes it a ground for bacteria attack.
Another possibility of tampons causing TSS is that the fibers of a tampon cause friction on the vagina leading to a scratch or wound. This creates an opening for staphylococcus and streptococcus bacteria to enter the bloodstream and cause TSS.
What Are The Risk Factors For TSS?
Here are the risk factors for this lethal disease:
- Skin infection
- A recent burn on the skin
- An open wound on the skin
- Skin treatment or surgery
- Use of tampons
- Using a vaginal sponge for contraception
- Giving birth to a baby recently
Symptoms of toxic shock syndrome
The symptoms of this fatal disease aren’t the same for one and all. They do vary from patient to patient where some people show symptoms suddenly and some people get symptoms after days or even weeks. The most common indications of this syndrome are:
- Getting fever
- Hypotension or low blood pressure
- Aching or paining muscles
- State of confusion
- Skin rash
- Red eyes
- Pale skin
Special Instructions For Women
- Since TSS is highly linked with menstruating women, there are some special instructions for women that Doctors give.
- Be extra cautious while using contraceptive vaginal sponges, tampons and diaphragms as these are risky for TSS.
- Women who ever got TSS or serious bacterial infection on the vaginal area are at a higher risk of getting TSS again. They should refrain from using tampons and various contraceptive tools.
- Practice good menstrual hygiene. The tampons now have an improved design which reduced the risk of TSS as compared to what it used to be a few years back.
Here are some instructions related to the use of tampons:
- Change your tampon at regular intervals depending upon the flow. It is better to change it every five to six hours, not more than that.
- It is suggested that you use low absorbency tampon
- Use sanitary napkins on days when the flow is light
- Avoid using tampons if you haven’t got a proper period
- Store the tampons in a cool and dry place to prevent bacteria buildup.,
- Sanitize your hands while handling tampons.
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Treatment For Toxic Shock Syndrome
This condition is very serious where the patient may die due to the absence of proper treatment as this is a skin condition that needs extensive care. Dr. Gaurav explains that the patient has to be kept in ICU and put on antibiotics. The patient is usually admitted to the hospital for a couple of weeks in the ICU until his/her health condition is stable. After treatment, the patient may recover completely in about one month.
The first and foremost thing a doctor would do after diagnosing TSS is that he/she will put you on antibiotics. This prevents TSS-causing bacteria from growing further. The dose of antibiotics depends on the condition of the patient.
In cases of severe TSS, doctors prefer immunoglobulin therapy to control the condition. In this, they inject immunoglobulin(a component of blood plasma) which has antibodies. This boosts your body’s immunity while building a strong defense against bacterial infection.
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