Toxic Shock Syndrome (TSS)

Staphylococcal Toxic Shock

Toxic shock syndrome, a type of blood poisoning, made headlines in the early 1980s when an outbreak of cases was linked to use of a new, highly absorbent tampon. The tampon was taken off the market and public concern waned. At the time, toxic shock syndrome was believed to be a new disease; scientists now realize that it has been in existence since the 1920s, but it was then regarded as a childhood disease called staphylococcal scarlet fever.

Although toxic shock syndrome no longer makes headlines, it is far from gone -- researchers estimate that there are 5,000 to 10,000 cases every year. Even with treatment, 2 to 4 percent of patients die, compared with a 15 percent mortality rare among the untreated.

The usual cause is a toxin produced by a strain of Staphylococcus aureus bacteria, organisms commonly found in the mucous membranes of the nose, mouth, and throat. If the bacteria enter the bloodstream, they can produce life-threatening poisons. Doctors now believe that the bacteria can invade the bloodstream through any cut or infection. Some cases of toxic shock have been associated with respiratory infections, including the flu.

Symptoms, which appear abruptly, include a fever above 102°F (38.9°C). vomiting, diarrhea, and a severe drop in blood pressure that can cause dizziness, fainting, and mental confusion. A red rash develops, followed a week or two later by peeling of the skin, especially on the palms and soles.

Diagnostic Studies and Procedures

Diagnosis of toxic shock syndrome is based on an evaluation of symptoms. The presence of fever, low blood pressure, and a peeling rash, as well as involvement of three or more organ systems -- the liver, kidneys, and intestines, for example -- points to the disorder. Blood studies and cultures may detect the S. aureus organism and help to confirm the diagnosis.

Medical Treatments

Time is essential in treating toxic shock syndrome. Immediate hospitalization, preferably in an intensive care unit, and administration of intravenous fluids and electrolytes, substances that maintain the body's chemical balance, are needed to counter the effects of shock and protect against kidney failure
It is important to find the bacteria's point of entry and foreign objects have to be removed immediately, any wounds or abscesses must be cleaned and, if appropriate, drained. Although antibiotics cannot neutralize the toxins that are causing the symptoms, they will be administered to eradicate the bacteria in the hope of preventing a recurrence of the infection.

In some cases, blood pressure may be reduced severely enough to cause death. In others, there may be tissue death and gangrene, especially of fingers and toes, and amputation may be necessary.

Alternative Therapies

Any alternative therapy must be used as an adjunct to intensive medical treatment and should be undertaken only with a physician's approval.

Naturopathy and Nutrition Therapy. As soon as the patient is again able to eat and drink, large quantities of fluids -- water, diluted juices, clear soups, and herbal teas -- are recommended. Some practitioners also advocate zinc lozenges and supplements of vitamins C and A to strengthen the immune system and promote recovery.

Physical Therapy. Recovering from toxic shock syndrome can be arduous, especially if the infection has resulted in tissue death and amputation. In such cases, physical and occupational therapists can help patients learn new ways of performing everyday tasks.

Other Causes of Toxic Shock or Similar Symptoms

Blood poisoning from Streptococcus A, a bacterium related to the strain that causes strep throat, can produce a syndrome similar to that of toxic shock. Kawasaki syndrome, a serious childhood illness, produces early symptoms like those of toxic shock syndrome but does not cause shock. Other diseases with similar symptoms that a doctor should rule out, especially in children, include scarlet fever and Rocky Mountain spotted fever.