Toxic shock syndrome (TSS) is characterized by sudden onset of fever, chills, vomiting, diarrhea, muscle aches and rash. It can rapidly progress to severe and intractable hypotension and multisystem dysfunction. Desquamation, particularly on the palms and soles can occur 1-2 weeks after onset of the illness.



Prevention

The bacteria that cause toxic shock syndrome can be carried on unwashed hands and prompt an infection anywhere on the body. So hand washing is extremely important.

Females can reduce their risk of TSS by either avoiding tampons or alternating them with sanitary napkins. If a girl uses only tampons, it's important to choose tampons with the lowest absorbency that will handle her menstrual flow and to change the tampons frequently. Between menstrual periods, it's a good idea to store tampons away from heat and moisture (where bacteria can grow) - for example, in a bedroom rather than in a bathroom closet.

Because staphylococcus bacteria are often carried on dirty hands, it's important to wash your hands thoroughly before and after inserting a tampon. If your daughter is just starting her menstrual period, she should know about taking these precautions. Any female who has recovered from TSS should check with her doctor before using tampons again.

The best defense against STSS is to clean and bandage all skin wounds as quickly as possible. Call your doctor immediately whenever a wound becomes red, swollen, or tender, or if a fever begins. Although STSS almost never follows strep throat, it's wise to check with your doctor whenever your child has a sore throat with fever, particularly if your child's condition is worsening despite medical treatment.

Diagnosis and Treatment

Call your doctor immediately if you experience the signs or symptoms of toxic shock syndrome, especially if you're menstruating or have just finished menstruating and have been using tampons. Tell your doctor what your symptoms are, how long you've had them and when your period started.

You may need to provide blood and urine samples to test for the presence of a staph infection. Samples from your vagina, cervix and throat may be taken for laboratory analysis by using cotton swabs.

Doctors typically diagnose TSS and STSS by doing a physical exam and conducting blood tests that assess a child's liver and kidney function. In toxic shock syndrome, doctors may want to rule out conditions like measles or Rocky Mountain spotted fever, which can produce similar symptoms. A doctor may also take samples of fluid from an abscess, boil, or infected wound to look for a possible source of staphylococcus or streptococcus infection.

Doctors typically treat TSS with antibiotics. If there is a pocket of infection, like an abscess, a doctor also may need to drain the infected area. A child who has TSS is monitored for signs of shock until the condition has stabilized and seems to be improving. Steroids are also sometimes used to treat severe cases of TSS.

As with TSS, doctors typically treat STSS with antibiotics and give intravenous fluids and medications to maintain normal blood pressure. Surgery is sometimes necessary to remove areas of dead skin and muscle around an infected wound.