Tampon toxic shock syndrome: symptoms, treatment. Toxic Shock Syndrome: When Quality Kills Toxic Shock Treatment

Toxic shock is extremely rare. But despite this, in most cases it carries a serious risk to human health.

This phenomenon can develop quickly and lead to negative processes in various organ systems, including the lungs, kidneys and liver.

ICD-10 code

A48.3 Toxic shock syndrome

Causes of toxic shock

The causes of toxic shock in most cases are associated with bacterial infection. They produce toxins, which lead to the development of toxic shock. Today they are quite common, but usually do not cause serious harm to the body. They can lead to throat or skin infections. All this can be easily eliminated and does not entail serious consequences. In rare cases, toxins enter the bloodstream and thus cause a strong immune reaction in people whose bodies do not fight them at all.

Streptococcal shock occurs during childbirth, influenza, chickenpox and surgery. It may develop against the background of minor cuts, wounds or bruises. Even the most ordinary bruises, which are not capable of disrupting the integrity of the skin, can cause the appearance.

Staphylococcal toxic shock occurs after prolonged use of tampons or after a surgical procedure. In many cases, it is almost impossible to prevent the development of this phenomenon.

Pathogenesis of infectious toxic shock

The pathogenesis of infectious toxic shock - at the level of small vessels is characterized by the fact that a large amount of toxins enters the circulatory system. They are secreted by saprophytic bacteria. This phenomenon leads to a sharp release of adrenaline and other biologically active substances. They can cause spasm of post-capillary venules and arterioles. The blood that circulates through the opened arteriovenous shunts cannot perform its direct function. Against this background, tissue ischemia and metabolic acidosis occur. Deterioration of circulation leads to tissue hypoxia; due to oxygen deficiency, anaerobic metabolism occurs.

At the level of organ systems, the pathogenesis of infectious toxic shock manifests itself in the form of blood deposition in capillaries and the release of its liquid part into the intercellular space. First, relative and then absolute hypovolemia occurs. A decrease in renal perfusion is possible. This leads to an excessive drop in glomerular filtration rate. The swelling that develops against this background causes acute renal failure. Similar processes occur in the lungs. That is why toxic shock carries considerable danger.

Symptoms of toxic shock

Symptoms of toxic shock develop quickly and rapidly. Moreover, all this is so fleeting that death can occur within 2 days.

The first signs of the “disease” include extremely severe consequences. So, there are sensations that are similar to the flu. Muscle pain, stomach cramps, headache and sore throat begin. The temperature may suddenly rise to 38.9. Vomiting and diarrhea are possible.

Over time, signs of shock appear. They are characterized by low blood pressure and rapid heart rate. Often all this is accompanied by dizziness, loss of consciousness, nausea, vomiting or dysphoria and confusion. Redness, similar to a sunburn, is possible. It can appear in several parts of the body or in separate places. This is mainly in the armpits or groin. There is severe pain at the site of infection. There is redness in the nasal passages and mouth.

Other symptoms include: conjunctivitis, blood poisoning, peeling of skin tissue and death of skin tissue. That is why toxic shock is extremely dangerous for humans.

Infectious-toxic shock

Infectious toxic shock is a sharp decrease in blood pressure. It occurs against the background of the negative effects of toxic substances that are produced by viruses or bacteria.

This type is often referred to as septic shock, bacteriotoxic shock, or endotoxic shock. This is an extremely nonspecific clinical syndrome. It occurs mainly in a number of infectious diseases due to metabolic, neuroregulatory and hemodynamic disorders caused by bacteremia (viremia) and toxemia.

Often it occurs against the background of meningococcal infection, influenza, fever, typhoid and typhus, diphtheria, salmonellosis, dysentery and other dangerous infections. The mechanism of pathogenic disorders in this case is determined by the type of pathogen, the nature of the treatment, the intensity of the ongoing pathological processes in the body (organ), their degree and other parameters. Toxic shock is a serious disorder in the body.

toxic shock syndrome

Toxic shock syndrome is a relatively rare disease. It is characterized by an abrupt onset. All this has serious consequences for human life. This syndrome can progress rapidly. Therefore, first aid measures must be carried out immediately.

There is a toxic shock syndrome against the background of infection with staphylococci and streptococci. Under normal conditions, they do not bother a person in any way. But under certain phenomena, they are able to release toxins that enter the bloodstream and lead to severe inflammatory reactions.

The reaction of the immune system leads to phenomena that are characteristic of toxic shock syndrome. The streptococcal variety of the "disease" is characteristic in the postpartum period, with complications after suffering acute respiratory infections, as well as with damage to the skin.

Staphylococcal syndrome occurs due to a forgotten tampon in the vagina. Therefore, you need to carefully monitor your own health. Because toxic shock is an extremely negative phenomenon for the body.

Toxic shock from tampons

Toxic shock from tampons can be caused by a staph infection. This mainly occurs due to a forgotten tampon in the vagina. The disease can progress quickly and lead to serious consequences. In some cases, it is not so easy to eliminate negative symptoms, and sometimes it is simply impossible. Lethal outcome is observed in 8-16% of cases.

Often this syndrome appears in women aged 15-30 years. Naturally, this is due to the use of tampons during menstruation. There were also cases when the syndrome appeared in women who prefer vaginal contraceptives.

The development of the disease is provoked by Staphylococcus aureus. These microorganisms are always present in the mouth, nose, vagina and skin. Under unfavorable conditions, they cause serious harm to the body. There is a particular danger if a woman has a birth injury, irritation or scratches in the vagina.

It must be understood that toxic shock develops much faster than the flu. Therefore, a sharp increase in body temperature and vomiting should cause concern in a woman. Toxic shock requires emergency treatment.

Bacterial toxic shock

Bacterial toxic shock is sometimes also called septic shock. It can complicate the course of sepsis at any stage of its development. This phenomenon is an altered reaction of the body to the breakthrough of pyogenic microorganisms or their toxins into the blood.

This manifests itself in the form of high temperature, sometimes reaching 40-41 degrees. In this case, there is a stunning chill, which is characterized by severe sweating. It is possible that the temperature may drop to normal or subfebrile due to severe sweating.

The mental state changes sharply. A person feels anxiety, motor agitation, and in some cases psychosis. These symptoms manifest themselves simultaneously with a drop in blood pressure and oliguria or even preceding them. The pulse is frequent and reaches 120-10 beats per minute. The skin becomes pale, acrocyanosis is noted and breathing becomes more frequent. Urinary excretion is severely impaired. Toxic shock requires immediate elimination.

Infectious toxic shock with pneumonia

Different types of pneumonia have their own characteristics. Often it can develop against the background of previous diseases, as a complication. Infectious toxic shock is a very serious complication. More often it occurs against the background of bilateral pneumonia.

Toxic shock also develops in severe pneumonia, which is characterized by severe infiltration of the lung tissue. An incipient complication can be identified by early signs. So, lethargy or anxiety manifests itself. Usually these symptoms do not attract attention, which leads to a worsening of the situation. Over time, shortness of breath and tachycardia appear, and pallor of the extremities is also possible. The skin becomes dry and warm. Toxic shock requires immediate elimination.

Infectious toxic shock in children

Infectious toxic shock in children is a serious and dangerous condition. It can be caused by complex infectious diseases. The reason for this phenomenon lies in the entry into the blood of microorganisms and the toxins they release during their life processes.

Toxins actively develop in the body and lead to spasms of small vessels and capillaries. Mostly in children, this phenomenon occurs against the background of scarlet fever, diphtheria, dysentery and meningococcal infection. Everything actively develops in the first day. At the same time, there is a sharp increase in temperature, up to 41 degrees.

The child's condition remains extremely difficult. He experiences headache, vomiting, severe chills, seizures and confusion. The pulse weakens, the heart begins to beat faster. There is pallor of the mucous membranes and skin, and heavy sweating is possible.

Infectious toxic shock in a baby can develop due to infection through an abrasion or cut. Children should be warned against this and their wounds should be treated promptly with a special antiseptic. If negative symptoms occur, you should immediately consult a doctor. Self-medication in this case is inappropriate! If toxic shock is not addressed correctly, a fatal outcome in this case is not excluded.

Stages of infectious toxic shock

There are four types of stages of infectious toxic shock. So, the first “variation” was called the early reversible shock phase. It is characterized by a shock index of up to 0.7-1.0, tachycardia, muscle pain, abdominal pain, headache and disorders of the central nervous system. Feelings of anxiety, restlessness and depression are possible.

The second stage is called the late reversible shock phase. At this stage, a critical drop in blood pressure occurs (below 90 mm Hg), and the shock index reaches 1.0-1.4. The victim has a rapid pulse, lethargy and apathy. There is a violation of blood microcirculation. This can be determined visually by wet and cold skin, as well as its bluish color.

The third stage is the phase of sustained reversible shock. The victim's condition deteriorates sharply. The pressure gradually drops, and the heart rate increases significantly. The shock index reaches 1.5. The bluish color of the skin and mucous membranes increases. Signs of multiple organ failure appear.

The fourth stage is the most dangerous - the phase of irreversible shock. General hypothermia sets in, the skin is a sick, sallow color with bluish spots around the joints. It is impossible to eliminate toxic shock in this case.

Diagnosis of toxic shock

There are several types of diagnosis of toxic shock. Everything can be determined by the patient himself. Thus, the patient has a very “sad” and “heavy” appearance. The person is conscious, but he is pale, cyanotic, adynamic and lethargic.

The difference between central and peripheral body temperature is up to 4°C. Diuresis less than 0.5 ml/kg/hour. The Algover shock index is gradually increasing. It is possible to determine whether a person has toxic shock visually and with additional measurement of blood pressure and pulse.

At the first stage, the patient's condition is serious. He is excited and in motor restlessness. The skin is pale, there is tachycardia, moderate shortness of breath and decreased diuresis. At the second stage, excitement is observed, which is eventually replaced by inhibition. In this case, the skin is pale, there is tachycardia, disseminated intravascular coagulation syndrome, hypoxia, hypokalemia and hypotension. At the third stage, severe cyanosis, impaired consciousness, drop in blood pressure, anuria and irreversible changes in organs. Toxic shock is life-threatening and must be treated immediately.

Treatment of toxic shock

Treatment of toxic shock includes a whole range of measures. The intensive therapy program for this disease consists of complete restoration of the body. The first step is to solve the main problems in the treatment of toxic shock. Then the fight against the source of infection in the body begins.

Next, exogenous and endogenous intoxication is eliminated. After a while, hypovolemia sets in and macrohemodynamic parameters stabilize. Then it is necessary to stop the mechanisms of auto-aggression and eliminate the deficiency of bioenergy.

It is important to improve microcirculation in a timely manner. In general, the main goals of therapeutic measures are to restore microcirculation and relieve disseminated intravascular coagulation. This is done by simultaneously persistent infusion therapy and intravenous administration of pharmacological drugs.

As noted above, treatment occurs in several stages and depends on the person’s condition. So, if shock occurs as a result of using tampons or contraceptives in a woman, you should immediately remove them from the body. Infected wounds are cleared of bacteria by scraping with a scalpel or scissors. To do this, the doctor gives an injection so that the damaged area is numb and the woman does not feel pain. This intervention is surgical treatment of the wound. Once the source of infection is removed, the patient will feel relief.

Hormones and antibiotics are actively used to destroy bacteria. Prednisolone and Dexamethasone are used as hormonal drugs.

Prednisolone is used to eliminate allergic reactions and the effects of toxic shock. It is used only with the permission of a doctor. It is used orally, by injection and topically. Orally - during or immediately after meals, 0.025–0.05 g per day (in 2–3 doses), then the dose is reduced to 0.005 g 4–6 times a day (or 2–3 times a day, 0.01 g ). In the form of injections - intramuscularly (the contents of the ampoule are dissolved in 5 ml of water for injection, heated to 35-37 ° C, 0.03-0.06 g of the drug each) and intravenously (0.015-0.03 g in a stream or drip). Locally - for anti-inflammatory and anti-allergic effects, 0.5% prednisolone ointment is used for skin diseases. The drug has some contraindications. It should not be used by elderly people or those who often suffer from herpes. Side effects such as water retention in the body, hyperglycemia, muscle weakness and amenorrhea cannot be excluded.

Dexamethasone. The product has anti-inflammatory, antiallergic, antishock, immunosuppressive and antitoxic properties. The drug is taken orally in the form of tablets in an amount of no more than 10-15 mg per day at the initial stage of treatment, followed by a reduction in the daily dose to 2-4.5 mg during maintenance therapy. The daily dose of the medication is divided into 3 doses. Maintenance small doses should be taken once a day, preferably in the morning. In ampoules, the product is intended for intravenous administration, intramuscular, perarticular and intra-articular. The recommended daily dose of Dexamethasone for these routes of administration is 4-20 mg. In ampoules, the medication is usually used 3-4 times a day for 3-4 days, followed by switching to tablets. The drug is used only with the permission of a doctor. It can cause side effects such as nausea, vomiting, and stomach pain. In more complex cases, the appearance of intracranial pressure, a tendency to develop infectious eye diseases and increased body weight cannot be ruled out. As for antibiotics, the most commonly taken are Vancomycin, Daptomycin and Linezolid.

Vancomycin. The drug is administered exclusively intravenously at a rate of no more than 10 mg/min. The duration of infusion should be at least 60 minutes. The daily dose for adults is 0.5 g or 7.5 mg/kg every 6 hours or 1 g or 15 mg/kg every 12 hours. If a person has impaired renal excretory function, the dosage regimen is adjusted. Under no circumstances should the drug be used during pregnancy, breastfeeding, or for people who have hypersensitivity to some components of the drug. It is possible that side effects such as nausea, vomiting and an allergic reaction may occur. In more complex cases, reversible neutropenia, anaphylactoid reactions and hyperemia occur.

Daptomycin. The drug is administered intravenously over at least 30 minutes. For complicated functions of the skin and soft tissues, 4 mg/kg once a day is sufficient for 1-2 weeks until the infection completely disappears. With bacteremia caused by Staph. aureus, including established or suspected infective endocarditis, the recommended dose for adults is 6 mg/kg 1 time/day for 2-6 weeks at the discretion of the attending physician. The drug may cause side effects. This manifests itself in the form of a fungal infection, mental disorders, nausea, vomiting and stomach pain. The appearance of hypersensitivity, swelling and chills is possible.

Linezolid. For adults, the drug is prescribed intravenously or orally 2 times a day, 400 mg or 600 mg once. The duration of treatment depends on the pathogen, localization and severity of the infection: for community-acquired pneumonia 600 mg - 10-14 days, hospital-acquired pneumonia 600 mg - 10-14 days, skin and soft tissue infections 400-600 mg depending on the severity of the disease - 14-28 days, enterococcal infections - 14-28 days. Taking the medicine incorrectly can cause side effects. They manifest themselves in the form of nausea, vomiting, stomach pain, headache and reversible anemia.

It should be noted that each case is in some way individual. Therefore, it is necessary to eliminate toxic shock only after examination by a doctor and identifying the stage of the “disease”.

Emergency care for infectious-toxic shock

Emergency care for infectious toxic shock should begin even before the person is hospitalized. Before the doctor arrives, you need to try to warm the person and put a heating pad on his feet. Then remove or unfasten tight clothing. This ensures access to fresh air.

Immediately after hospitalization, the person is transferred to the intensive care unit. Appropriate therapy is carried out here. Blood cultures are performed before antibiotics are prescribed. If possible, then all this is removed from the foci of infection.

The complexity and severity of the septic process requires treatment aimed not only at combating microorganisms, but also at eliminating metabolic disorders caused by intoxication and hypoxia. After vital functions are restored, the foci of infection are sanitized. For emergency care, use: intravenous drip administration of 200 mg of Dopamine, prednisolone at a dose of 10-15 mg/kg/day and oxygen inhalation. Further treatment depends on the condition. In any case, toxic shock must be eliminated immediately.

If a woman has experienced menstrual toxic shock syndrome, then she should stop using intrauterine devices, tampons and barrier contraceptives. Toxic shock is a serious disorder that can lead to disruption of the functions of organs and body systems.

Toxic shock prognosis

The prognosis for toxic shock is relatively favorable. The success of recovery in people who have suffered this complication depends on timely diagnosis and treatment.

It is important that emergency assistance is provided quickly and professionally. Antibacterial therapy must be adequate as well as successful. The main thing is that the sanitation of the main bacterial focus is carried out correctly and effectively.

Despite this, the mortality rate is high, but only in the first hours. If infectious toxic shock was caused by streptococcus, the mortality rate reaches 65%. The causes of death are heart failure, multiple organ failure and arterial hypotension. With timely and adequate care, the patient recovers completely in 2-3 weeks. You need to understand that prevention is much easier than cure. Toxic shock is a serious disorder that negatively affects many systems and organs of the human body.

Toxic shock syndrome from tampons is the topic of the article. You will learn the cause and symptoms of the disease. And also what threat feminine hygiene products pose. What can replace pads and tampons?

Tampon toxic shock syndrome

Toxic shock syndrome from tampons is a serious disease that manufacturers do not write about on the packaging of feminine hygiene products. Although this pathology is rare, it is progressing more and more every day.

The disease at the first stage resembles the flu, so people begin to treat themselves for a cold, without taking into account the seriousness of the situation. Pay attention to signs such as muscle spasms, severe headaches and stomach discomfort, fever, vomiting, diarrhea, and rash on the palms. It is better to immediately seek help from a specialist who will prescribe appropriate tests and then treatment.

Causes

So, we have looked at the symptoms of toxic shock syndrome. Now let's discuss the causes of the disease. There are several of them.

Using tampons on a regular basis. Vaginal contraceptives. Childbirth. Disturbances in the functioning of the reproductive system. Candidiasis, bacterial vaginosis. Failure to comply with hygiene rules and improper use of Tampax. Weak immunity.

The disease develops very quickly, affecting almost all organs of the body. These include the liver, kidneys, skin and even blood vessels. The worst thing is that toxic shock syndrome can lead to death. A stable healthy immune system and good hygiene will help get rid of the infection as soon as possible.

As you can see, the reasons are visible and can be easily eliminated.

Complications of toxic shock syndrome

Like any other disease, toxic shock syndrome causes complications. Doctors include:

relapse of toxic shock syndrome;
heart, kidney and liver failure;
blood poisoning;
deterioration of vision, attention, hearing.

Treatment of an infectious disease

Treatment for toxic shock syndrome can be long and drawn out. After first aid is provided to the victim, therapy of the highest intensity is prescribed.

Includes observation, restoration of vascular function, maintaining blood pressure in a normal state, the use of glucocorticoids, antibiotics, and the use of antistaphylococcal immunoglobulin. With timely treatment, you can get rid of the manifestations of the disease within 2-3 days.

The dangers of using tampons

So, one of the reasons for the development of the disease is the uncontrolled use of tampons. Let's analyze their composition. Innovative models have components that, if used frequently, negatively affect a woman’s body.

Dioxin. The substance is used as a bleach. This component can cause cancer, disrupts the functioning of the immune and reproductive systems, causing endometriosis.

Viscose. It absorbs blood in the best way, but when the tampon is removed, the fibers of the component may remain on the mucous membrane.

Cotton. The fibers that remain on the vaginal walls when the tampon is pulled out are associated with the appearance of ulcers and minor injuries.

But these are not all the negative aspects of using tampons. Their negative impact lies in the incorrect outflow of blood, which sometimes ensures the return of fluid.

Deformation of the inner part of the vagina (in an aerobic environment, staphylococcal syndrome rapidly develops and bacteria multiply; toxins of Staphylococcus aureus appear). A decrease in the number of lactic acid bacteria leads to activation of the pathogenic flora of the vagina.

Experts advise changing the tampon every 3-4 hours, otherwise bacteria formed in the blood will immediately spread to the genitals.

Failure to promptly replace a tampon can lead to toxic shock syndrome.

Feminine pads

On menstruation days, more than ever, you want more cleanliness, comfort and coziness. It is believed that sanitary pads are one of the effective ways to protect yourself during the menstrual cycle.

But these protective measures are dangerous to health. 63% of diseases in women develop due to their improper use.

Types of gaskets

Today on the hygiene products market you can find a fairly wide selection of pads. They are disposable and reusable. Among them, there are pads for regular use (they absorb blood of medium intensity).

For daily use (they will become indispensable for small and weak mucous secretions, and also eliminate unpleasant odors).

They are ultra-thin (the structure of the models is quite thin, but they absorb very small amounts of moisture).

M axi (they have a fairly decent size and absorb a large amount of secretions; such models are used for long trips or during night sleep).

With special sleeping pads (ensure a restful night's rest, complete protection from unexpected stains).

How to choose gaskets

Despite the wide range of products on the consumer market, all products have the same structure.

The uppermost layer of the pad consists of an artificial or cotton mesh (it has a big plus, since it is always in a dry state and does not deform the product). The inner layer consists of a special filler (it thoroughly absorbs moisture, quite often causes skin irritation). The bottom layer is made of polyethylene or a breathable material that does not allow liquid to pass through.

Each pack of pads has a droplet designation that indicates the absorption rate of the product (the more there are, the higher the level of absorption; the “wings” perfectly protect the underwear from stains and unpleasant contamination).

Most manufacturers produce scented hygiene products to eliminate unpleasant odors, but they can cause allergies (be aware of this danger when buying).

Situations of the appearance of thrush are known, after the use of flavored pads.

I advise you to buy odorless and colorless hygiene protective products - think about your safety.

Negative effects of gaskets

It may seem that the pads are harmless. But this is a mistaken opinion. What disadvantages do they have?

During active walking, the pads become wrinkled or move to the side. You feel discomfort while using this hygiene product. Allergic reactions appear, unpleasant itching and irritation are felt. Cystitis or thrush occurs, and an unpleasant odor occurs.

Pads prevent you from leading an active lifestyle. A greenhouse effect is created, allowing infections to penetrate deep into the cervix or remain on the mucous membrane. Otherwise, the effect of using pads is quite acceptable during menstrual periods.

Preventing toxic shock syndrome from tampons

So, tampon toxic shock syndrome is a disease caused by a bacterial infection. It is necessary to use preventive measures, and the disease will certainly bypass. During your period, alternate the use of tampons with pads and take breaks.

Buy products with absorbent capacity that will accommodate the amount of blood discharge. Change the product every 3-4 hours.

If you don’t know how to replace pads and tampons, read about menstrual guards.

So, today you learned about a disease called toxic shock syndrome from tampons. Surely, you should have been surprised by the dangerous components that make up seemingly absolutely harmless tampons.

I think that a menstrual cup is a good alternative to the hygiene products described above. What do you think? Share your opinion in the comments.

Best regards, Tina Tomchuk

Tampons appeared in the distant 30s. Since that time, they have become a real lifesaver for girls. Thanks to these hygiene products, during your period you can wear tight clothes, play sports, dance, go to the pool and not feel any discomfort.

But many gynecologists are against tampons. Some health problems are associated with their use: thrush, inflammatory processes, dysbacteriosis. Tampon shock is the most dangerous disease. How to avoid unpleasant consequences from using these hygiene products, we will consider in the article.

toxic shock syndrome

Toxic shock syndrome (TSS) is a manifestation of severe intoxication (poisoning) of the body by bacteria. The disease develops at lightning speed and always occurs in an acute form.

It is important! You will not be able to cope with toxic shock syndrome on your own. At the first symptoms of the disease, a woman must seek medical help. Otherwise, complications can go to the kidneys and liver, up to the complete failure of these organs.

Toxic shock syndrome is caused by a number of bacteria and microorganisms:

streptococci;
staphylococci;
malarial plasmodium.

Bacteria “throw out” toxins into the blood, thereby poisoning the woman’s body. Through the plasma, they enter the main vital organs (liver, kidneys, brain), the patient develops an acute pathological condition.

Why don't all women who use tampons during their period have TSS? The thing is that most adults have encountered such bacteria or microorganisms at least once in their lives and have developed antibodies to toxins.

That is why toxic shock syndrome in most cases occurs in adolescents and girls under the age of 30.

The first signs of TSS resemble the common flu:

increased body temperature (above 39 degrees);
blood pressure surges;
convulsions;
dizziness and loss of consciousness;
body aches.

Many patients think that they have caught a common flu virus and begin active treatment for a cold, not realizing the gravity of the situation. The insidiousness of toxic shock syndrome is that the disease develops rapidly. If you do not remove the tampon in time and do not seek medical help, you can get complications, even death.

First symptoms

TSS occurs very quickly during menstruation and is always acute. Without proper treatment, death can occur within 3–4 days.

That is why every girl who uses tampons should know the symptoms of toxic shock syndrome:

Low blood pressure. There is perspiration and pale skin on the patient's face. It gets to the point where the woman cannot remain in an upright position and loses consciousness.
Increased body temperature (39-40 degrees).
Nausea, vomiting, loose, foamy stools.
Muscle pain, cramps.
Redness of the throat mucosa.
The occurrence of conjunctivitis, souring of the eyes.
Small amount of urine.
Swelling of the genital organs.
Sharp pain in the lower abdomen and lumbar region.
Labored breathing.
On days 4-5, red spots may appear on the skin, which look more like burns.
On days 7-14, the skin on the palms and soles begins to peel and peel off.
Development of sepsis.
Damage to the liver, kidneys, central nervous system.

It is important! If, while using tampons, your stomach hurts severely, your temperature rises, or your blood pressure drops, seek medical help immediately. In 80% of cases, the doctor will diagnose TSS. You should not wait for accompanying symptoms and worsening of the condition. At the initial stage, toxic shock syndrome responds well to treatment, complications are extremely rare.

Specific treatment for toxic shock syndrome

It is worth remembering that TSS is an insidious disease that progresses very quickly. Therefore, his treatment will be long and painful.

First aid for a woman who detects symptoms of TSS should be as follows:

Removing the tampon.
Ventilate the room so that there is access to oxygen.
Relief from constricting, closed clothing.
Bed rest.
Warm foot warmer.
Call an ambulance.

Prevention of the syndrome

Is it possible to avoid TSS when using tampons? To prevent this disease, doctors advise adhering to the following rules:

The time of using tampons should not exceed 4 hours. In this case, the risks of developing pathogenic bacteria are minimized. In isolated cases, the time can be increased up to 8 hours. After this, be sure to wash yourself with intimate hygiene gel to restore the vaginal microflora, and put on a pad.
Do not use tampons at night.
Correctly choose the size of the hygiene product and its absorbency.
Alternate between wearing tampons and pads.
Choose hygiene products of proper, proven quality. Make sure that the tampon does not contain genetically modified cotton, which is often used by manufacturers to reduce the cost of the product. If this component is present, the risk of developing staphylococcal toxins increases dramatically.
If after using a tampon there is itching, burning or redness in the vagina, it is better to avoid these hygiene products.

The life of a modern girl is designed in such a way that she always needs to be in shape, even during her period. Undoubtedly, tampons are simple and convenient to use, they are invisible under clothing and do not hinder movement. But, nevertheless, every girl, using these hygiene products, should know and use the rules that were described above. In this case, the risks of developing TSS are minimal.

Other names: infectious-toxic shock

Toxic shock syndrome (TSS) is a rare but serious infectious disease, most often caused by the bacterium “staphylococcus” (Staphylococcus). This bacterium is present in people in the mucous membrane: nose, throat, vagina, perineum.

In most cases, this bacterium is not dangerous. But in people with low immunity, bacteria can multiply, causing infection and spreading toxins. These toxins enter the bloodstream and attack various organs: the liver, kidneys and lungs.

The infection is similar to the flu and in rare cases can lead to death.

Causes

The main cause of toxic shock syndrome is the use of vaginal tampons or menstrual cups for too long a period (more than 4-6 hours).

During menstruation, the pH of the vagina changes. It becomes alkaline (less acidic). This medium provides a favorable culture medium for Staphylococcus aureus. So, if blood sits in the vagina for too long, bacteria can develop and cause an infection.

TSS came to public attention in 1980, when more than 700 women were infected in North America.

Toxic shock syndrome is not always associated with tampon use and can occur after surgery or accidental injury.

Symptoms

Symptoms of toxic shock syndrome appear suddenly:

Confusion, dizziness.
Severe fatigue, weakness.
High temperature between 39°C and 40.5°C.
Headache.
Redness of the eyes, vagina.
Acute diarrhea, vomiting.
A sore throat.
Extensive rash accompanied by redness.

At the primary stage of infection, symptoms resemble flu (pain in muscles, joints, throat, fever). Then red rashes appear. Added to this is indigestion (diarrhea, vomiting). Only after this shock is manifested by low blood pressure, tachycardia, and confusion. After 1-2 weeks, the skin begins to peel off, especially on the palms and soles of the feet.

Diagnostics

Diagnosis of TSS requires a clinical examination. Blood or tissue tests may be performed to look for microorganisms. Other tests may be performed, such as an electrocardiogram, x-ray, computed tomography scan, or magnetic resonance imaging (MRI).

Treatment

If these symptoms occur, your first instinct is to remove your tampon or menstrual cup.

Second reflex: go to the hospital.

People suffering from toxic shock syndrome require intensive care. Treatment consists of oral and intravenous therapy to maintain blood pressure.

Wounds and all sources of infection are washed with water and thoroughly cleaned. Antibiotics are given intravenously to reduce the risk of recurrent infection.

Prevention

Fortunately, toxic shock syndrome is less common now than it was in the 1980s, with the most dangerous tampon models being removed from the market. The following measures also help women reduce their risk of developing toxic shock syndrome:

During heavy periods, alternate using tampons and pads.
Change tampons and pads every 4-6 hours.
Maintain good general hygiene, especially in the vaginal area.
Use a pad at night.

Severe acute multiorgan damage caused by exotoxins of Staphylococcus aureus or Streptococcus pyogenes. It manifests itself as a sudden increase in temperature to 38.9°C or more, a drop in blood pressure, erythematous skin rashes followed by peeling, profuse diarrhea, vomiting, and signs of damage to various organs and systems. The diagnosis of TSS is established on the basis of the clinical picture, physical examination data, and laboratory, including bacteriological, tests. Treatment involves sanitizing the bacterial focus, prescribing antibiotics, infusion and symptomatic therapy.

ICD-10

A48.3

General information

Toxic shock syndrome (TSS) was first diagnosed in 1978 in seven children with staphylococcal infections. Specialists in the field of gynecology encountered it two years later, noting the connection between the development of the syndrome in young women and the use of superabsorbent hygienic tampons during menstruation. The vast majority of patients are women aged 17-30 years. In approximately half of them, the development of the syndrome is associated with menstruation. In a quarter of cases of nonmenstrual TSS, the disease occurs in the postpartum period in carriers of Staphylococcus aureus, in 75% - as a result of other causes (skin and subcutaneous infection, previous operations with tamponing, etc.).

Causes of TSS

Toxic shock syndrome is caused by exotoxin-producing microorganisms that have a systemic effect on various organs and tissues - Staphylococcus aureus and group A pyogenic β-hemolytic streptococcus (Streptococcus pyogenes). In most cases, the disease does not occur at the time of primary infection with bacteria, but against the background of carriage of infectious pathogens under the influence of the following predisposing factors:

Using tampons. The likelihood of developing TSS increases when using hygiene products with increased adsorbent properties and violating the recommended frequency of their replacement.
Use of intravaginal contraceptives. The presence of diaphragms, sponges, and caps in the vagina creates favorable conditions for the proliferation of microorganisms.
Violation of the integrity of the mucous membranes. In case of injuries to the genital organs, the presence of remnants of placental tissue, fetal membranes, blood after childbirth and gynecological operations in the uterus, optimal conditions arise for bacterial contamination and the penetration of microorganisms or their toxins into the blood.

Nonmenstrual toxic shock syndrome can complicate surgical procedures that use dressings that accumulate blood (surgeries on the nasal cavity using turundas, wound packing, etc.) and traumatic skin injuries. The combination of these factors with viral diseases (chickenpox, influenza) and the use of immunosuppressive drugs increases the risk of developing toxemia and bacteremia.

Pathogenesis

A key role in the development of toxic shock syndrome is played by mechanical and chemical influences, which promote the proliferation of bacteria and affect tissue permeability. The trigger point is the penetration of significant quantities of specific toxins (TSST) into the blood and their interaction with T-lymphocytes. As a result, cytokines are massively released, causing a multi-organ toxic reaction. The vessels dilate and the permeability of their walls increases, which leads to the movement of blood plasma and serum proteins into the extravascular space. In this case, a sharp drop in pressure is observed, swelling occurs, coagulation is disrupted, and the temperature rises. Under the influence of indirect immune reactions and the direct action of toxins, the skin, parenchyma of the liver, lungs and other organs are affected.

Symptoms of TSS

In menstruating women who use tampons, signs of TSS appear on the 3rd to 5th day of their period. In case of toxic shock syndrome, which complicates childbirth or gynecological operations, the pathology manifests itself in the first 2 days of the postpartum or postoperative period. As a rule, the disease occurs acutely. In rare cases, a prodrome is observed in the form of general malaise, nausea, headache and muscle pain. The first sign of TSS is severe chills with an increase in temperature to 39-40°C, after which the full clinical picture develops within 1-4 days.

Almost all patients experience muscle weakness and diffuse pain in the muscles, especially in the muscles of the proximal limbs, abdominals and back. Joint pain is common. More than 90% of patients report persistent vomiting and profuse watery diarrhea, and a scanty amount of urine. A sore throat, paresthesia, headache, photophobia, dizziness and fainting occur due to a drop in blood pressure. In some cases, coughing and painful sensations when swallowing are bothersome. In the acute stage, which lasts 24 to 48 hours, the patient appears lethargic and disoriented.

A specific manifestation of the syndrome is skin rashes in the form of diffuse redness, which resembles a sunburn and begins to gradually fade over the first 3 days. Subsequently, rough peeling of the skin occurs, especially noticeable on the soles and palms. In some women, redness is in the form of spots of various sizes, which are joined by small nodular rashes or pinpoint petechial hemorrhages. Almost a quarter of the sick on the 5-10th day there is severe itching against the background of a spotty-nodular rash. In almost 100% of patients, by the end of the 1st-2nd week, a shallow generalized scaly exfoliation of the skin epithelium with a more pronounced lamellar peeling of the palms, soles, fingers and toes is observed. Half of the patients who underwent TSS by the end of the 2-3rd month noted hair loss and convergence of nails.

In almost 3/4 cases, hyperemia of the conjunctiva, redness of the posterior pharyngeal wall and oral mucosa, crimson-red color of the tongue are detected. Every third menstruating woman with TSS is concerned about soreness and swelling in the area of the labia majora and labia minora. In severe cases of the syndrome, there are signs of toxic damage to the liver, kidneys, respiratory system with transient icterus of the skin, pain in the abdomen, lower back, right hypochondrium, cloudy urine, shortness of breath, etc.

In addition to the clinically pronounced toxic shock syndrome, there is its erased form (with primary manifestation or repeated episode): the patient has a fever, chills, moderate muscle pain, nausea, vomiting, diarrhea, and a sore throat. However, blood pressure does not decrease and the condition resolves without treatment.

Complications

In severe cases of the syndrome, toxic shock is observed, leading to impaired microcirculation and aggravating damage to parenchymal organs. Respiratory failure occurs with shortness of breath and deterioration of blood oxygenation, DIC with thromboembolism and heavy bleeding, heart rhythm is disturbed, as a result of acute tubular necrosis, the kidneys fail. More than 50% of patients with streptococcal TSS develop bacteremia and necrotizing fasciitis. In the long term, temporary loss of nails and hair, neurological disorders (paresthesia, memory disorders, increased fatigue) are possible.

Diagnostics

Taking into account the multiorgan nature of the disease, in order to make a diagnosis, it is necessary to evaluate both local changes in the female organs and signs of violations of other systems. The comprehensive examination includes:

Examination by a gynecologist. Puffiness and hyperemia of the genital organs are revealed, in some cases - scanty discharge of a purulent nature from the cervical canal. Palpation can detect pain in the appendage area.
Physical examination. In 100% of cases, there is an increase in temperature over 38.9°C and a drop in systolic pressure below 90 mm Hg. (usually with an orthostatic decrease of 15 mmHg).
General clinical tests. KLA is characterized by leukocytosis with high neutrophilia, shift of the leukocyte formula to the left, thrombocytopenia, anemia, increased ESR. In the general analysis of urine, an abnormal urinary sediment with leached erythrocytes and sterile pyuria is determined.
Blood chemistry. With impaired liver function, the level of bilirubin and the activity of transferases increase (it is detected in almost half of the patients), with renal failure, azotemia and creatininemia occur, and with muscle damage, an increased content of CPK. In the coagulogram, prothrombin time and partial thromboplastin time increase, fibrin degradation products are determined. A blood test for electrolytes reveals metabolic acidosis, a decrease in the level of calcium, phosphorus, sodium, potassium.
Methods for determining the pathogen. To identify an infectious agent, a bacterial smear from the genital organs with an antibiogram and blood cultures are used (indicated for suspected streptococcal TSS). Serological studies make it possible to assess the parameters of the immune system and exclude infectious diseases with a similar clinical picture.
Instrumental diagnostics. An ECG allows timely detection of heart rhythm disturbances. Fluorography or radiography of the chest cavity is recommended for assessing the condition of the lungs.

TS syndrome is differentiated from sepsis and infectious diseases (measles,

Antibiotic therapy. The choice of drug is based on the results of determining sensitivity to antimicrobial agents. Until such data is obtained, empirical therapy is prescribed taking into account the likely pathogen and its possible antibiotic resistance. The course lasts up to 10 days.

Infusion therapy. The key element of treatment is restoration of intravascular fluid volume and stabilization of hemodynamic parameters. Depending on the nature of the disorders, the patient is infused with crystalloid solutions, electrolytes, fresh frozen blood plasma, platelet mass, etc.

Vasopressors. If correction of intravascular fluid volume does not normalize blood pressure, drugs with a pressor effect are administered.

In case of severe organ failure, the patient may be prescribed hemodialysis (for acute renal failure), artificial ventilation with positive expiratory pressure (for respiratory distress syndrome). A number of authors note faster recovery when prescribing corticosteroids and immunoglobulins.

Prognosis and prevention

In most cases, thanks to the achievements of modern gynecology, timely diagnosis and treatment, patients with staphylococcal TSS recover in 1-2 weeks, while the mortality rate at the present stage is 2.6%. Temperature and blood pressure normalize within 2 days from the moment of hospitalization, and laboratory parameters - on the 7-14th day. The level of red blood cells is restored after 4-6 weeks. With streptococcal toxic shock, the mortality rate is still high and reaches 50%. To prevent TSS, it is important to follow recommendations for the use of tampons and examination protocols before childbirth and gynecological operations to ensure timely identification of pathogens.