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 infection by bacteria. 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 is easily eliminated and does not entail serious consequences. In rare cases, toxins enter the bloodstream and thereby cause a strong immune response in people whose bodies do not fight them at all.

Streptococcal shock appears during childbirth, influenza, chickenpox and operations. Development on the background of mild cuts, wounds or bruises is possible. Even the most ordinary bruises, which are not capable of violating the integrity of the skin, can become the cause of the appearance.

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

The 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 enter 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 postcapillary 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. The deterioration of circulation leads to the appearance of 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, there is a relative, and then an absolute hypovolemia. A decrease in renal perfusion is not excluded. This results in an excessive drop in glomerular filtration. The edema that develops against this background causes acute renal failure. Similar processes occur in the lungs. That is why toxic shock carries a 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 a "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 not ruled out.

Over time, signs of shock appear. They are characterized by low blood pressure and palpitations. Often all this is accompanied by dizziness, loss of consciousness, nausea, vomiting or dysphoria and clouding of consciousness. Redness, which is similar to a sunburn, is not ruled out. It can appear in several parts of the body or in separate places. Mostly under the armpits or in the groin. There is severe pain at the site of infection. There is redness of 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 a highly non-specific 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 has an abrupt onset. All this has serious consequences for human life. This syndrome can progress rapidly. Therefore, first aid measures must be taken 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 appears 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 is mainly due to a forgotten tampon in the vagina. The disease can progress rapidly 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 critical days. 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 on the skin. Under adverse conditions, they cause serious harm to the body. A particular danger is observed 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 anxiety in a woman. Toxic shock is an emergency.

Bacterial toxic shock

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

This manifests itself in the form of a high temperature, sometimes it reaches 40-41 degrees. At the same time, there is a tremendous chill, which is characterized by severe sweating. It is possible that the temperature drops to normal or subfebrile, due to heavy sweating.

The mental state changes dramatically. A person feels anxiety, motor excitement, 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 quickens. The urination is sharply broken. Toxic shock requires immediate elimination.

Infectious toxic shock in 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. The beginning complication can be determined by early signs. So, inhibition or anxiety manifests itself. Usually these symptoms do not attract attention, which leads to a worsening of the situation. Over time, shortness of breath, tachycardia appears, and pallor of the extremities is not excluded. 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 the life process.

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 develops actively in the first day. In this case, there is a sharp increase in temperature, up to 41 degrees.

The child's condition remains extremely difficult. He has a headache, vomiting, severe chills, convulsions and confusion. The pulse weakens, the heart begins to beat faster. Paleness of the mucous membranes and skin is observed, severe sweating is not excluded.

Infectious toxic shock in a baby can develop against the background of infection through an abrasion or cut. Children need to be warned against this and treat wounds with a special antiseptic in time. If negative symptoms occur, you should immediately consult a doctor. Self-medication in this case is inappropriate! If toxic shock is not started to be eliminated correctly, a lethal outcome in this case is not excluded.

Stages of infectious toxic shock

The stages of infectious toxic shock are of four types. So, the first "variation" has received the name - a phase of early reversible shock. 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 not ruled out.

The second stage is called the late reversible shock phase. At this stage, there is a critical drop in blood pressure (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 cyanotic color.

The third stage is the phase of stable reversible shock. The victim's condition is rapidly deteriorating. The pressure gradually drops, and the heart rate increases significantly. The shock index reaches 1.5. The cyanotic color of the skin and mucous membranes increases. There are signs of multiple organ failure.

The fourth stage is the most dangerous - the phase of irreversible shock. There comes a general hypothermia, the skin of the sick earthy shade with cyanotic spots around the joints. Eliminate toxic shock in this case is impossible.

Diagnosis of toxic shock

Diagnosis of toxic shock is of several types. Everything can be determined by the patient himself. So, the patient has a very "sad" and "heavy" appearance. The person is conscious, while he is pale, cyanotic, adynamic and inhibited.

The difference between the 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 an additional measurement of pressure and pulse.

At the first stage, the patient's condition is severe. He is agitated and in motor restlessness. The skin is pale, there is tachycardia, moderate shortness of breath and decreased diuresis. At the second stage, excitation is observed, which over time is replaced by inhibition. At the same time, the skin is pale, there is tachycardia, DIC syndrome, hypoxia, hypokalemia and hypotension. In the third stage, pronounced cyanosis, impaired consciousness, drop in blood pressure, anuria and irreversible changes in the organs. Toxic shock is life-threatening and must be treated immediately.

Treatment for toxic shock

Treatment of toxic shock includes a whole range of measures. The intensive care program for this disease consists in the complete restoration of the body. First of all, the main tasks in the treatment of toxic shock are solved. Then the fight against the source of infection in the body begins.

Next is the elimination of exogenous and endogenous intoxication. After a while, hypovolemia and stabilization of macrohemodynamic parameters are connected. Then it is necessary to stop the mechanisms of auto-aggression and eliminate the deficit of bioenergy.

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

As noted above, treatment occurs in several stages and depends on the condition of the person. So, if the shock resulted from the use of tampons or contraceptives in a woman, it is worth immediately removing them from the body. Infected wounds are cleaned of bacteria by scraping with a scalpel or scissors. To do this, the doctor makes an injection so that the damaged area becomes numb and the woman does not feel pain. This intervention is the surgical treatment of the wound. As soon as the source of infection is removed, the patient will feel relief.

Hormones and antibiotics are actively used to kill 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. Apply it inside, in the form of injections and topically. Inside - 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 each). ). 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) and intravenously (stream or drip, 0.015-0.03 g). Locally - for anti-inflammatory and anti-allergic action, 0.5% prednisolone ointment is used for skin diseases. The drug has some contraindications. It should not be used by the elderly and those who often have herpes. Side effects in the form of water retention in the body, the manifestation of hyperglycemia, muscle weakness and amenorrhea are not excluded.

Dexamethasone. The tool has anti-inflammatory, anti-allergic, anti-shock, immunosuppressive and anti-toxic properties. Oral take the drug in the form of tablets in an amount of not more than 10-15 mg per day at the initial stage of treatment, followed by a decrease in the daily dose to 2-4.5 mg with maintenance therapy. The daily dose of the drug is divided into 3 doses. Maintenance small doses should be taken once a day, preferably in the morning. In ampoules, the agent is intended for intravenous administration, intramuscularly, periarticularly and intraarticularly. The recommended daily dose of Dexamethasone for these routes of administration is 4-20 mg. In ampoules, the drug is usually used 3-4 times a day for 3-4 days, followed by the transition to tablets. The drug is used only with the permission of the 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 weight gain are not excluded. As for antibiotics, Vancomycin, Daptomycin, and Linezolid are the most commonly used.

Vancomycin. The drug is administered exclusively intravenously at a rate of not more than 10 mg / min. The duration of the 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, then the dosage regimen is corrected. In no case should you use the drug during pregnancy, during breastfeeding and people with hypersensitivity to some components of the drug. It is not excluded the appearance of side effects in the form of nausea, vomiting and an allergic reaction. In more complex cases, reversible neutropenia, anaphylactoid reactions and hyperemia are formed.

Daptomycin. The drug is administered intravenously for at least 30 minutes. With complicated functions of the skin and soft tissues, 4 mg / kg is enough once a day for 1-2 weeks until the infection disappears completely. 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 pain in the stomach. It is not excluded the appearance of hypersensitivity, swelling and chills.

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: with community-acquired pneumonia, 600 mg - 10-14 days, nosocomial pneumonia, 600 mg - 10-14 days, infections of the skin and soft tissues, 400-600 mg, depending on the severity of the disease - 14-28 days, enterococcal infections - 14-28 days. Incorrect use of the drug can cause side effects. They manifest as 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 examining a doctor and identifying the stage of the “disease”.

Emergency care for infectious-toxic shock

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

Immediately after hospitalization, the person is transferred to the intensive care unit. This is where the therapy comes in. Before antibiotics are prescribed, blood cultures are performed. If possible, then all this is removed from the foci of infection.

The complexity and severity of the course of the septic process requires treatment aimed not only at fighting microorganisms, but also at eliminating metabolic disorders caused by intoxication and hypoxia. After the vital functions are restored, the foci of infection are sanitized. For emergency use: intravenous drip of 200 mg 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 treated 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 deviation that can lead to disruption of the functions of organs and body systems.

Toxic shock prognosis

The prognosis for toxic shock is relatively good. The success of recovery in people who have undergone this complication depends on the timeliness of 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 should be carried out correctly and efficiently.

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

Tampon toxic shock syndrome is the topic of the article. You will learn the cause and symptoms of the disease. And also what kind of threat is fraught with feminine hygiene products. What can replace pads and tampons.

tampon toxic shock syndrome

Tampon Toxic Shock Syndrome is a serious disease that manufacturers do not list on the packaging of feminine hygiene products. This pathology, although rare, is progressing more and more every day.

The disease in the first stage resembles the flu, so people themselves begin to be treated for a cold, not taking into account the seriousness of the situation. Look for signs such as muscle cramps, acute headaches and stomach discomfort, fever, vomiting, diarrhea, rashes on the palms. It is better to immediately seek help from a specialist who will prescribe the appropriate tests, and then treatment.

The reasons

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

Regular use of tampons. Vaginal contraceptives. Childbirth. Violations of 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. Stable healthy immunity and hygiene rules will help get rid of the infection in the shortest possible time.

As you can see, the causes 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 providing first aid to the victim, therapy of the highest degree of intensity is prescribed.

Includes - observation, restoration of vascular function, maintenance of blood pressure in a normal state, the use of glucocorticoids, antibiotics, 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, with frequent use, negatively affect a woman's body.

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

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

Cotton. The fibers remaining on the walls of the vagina during the pulling out of the tampon accompany the appearance of sores and minor injuries.

But these are not all the negative aspects of using tampons. Their negative impact is not the correct outflow of blood, which sometimes provides a reverse return of fluid.

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

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

Untimely replacement of a tampon leads to the occurrence of toxic shock syndrome.

Feminine pads

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

But these remedies are hazardous to health. 63% of diseases in women develop due to their misuse.

Types of gaskets

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

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

They are ultra-thin (in their structure, the models are quite thin, but they absorb a very small amount of moisture).

Maxi (they have a fairly decent size and absorb a large amount of secretions; such models are used for a long trip or during a night's sleep).

With special pads for sleeping (provide a quiet rest at night, full protection from unforeseen stains).

How to choose pads

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

The topmost 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 is labeled with droplets, which indicates the absorption rate of the product (the more of them, 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.

The negative impact of pads

It may seem that pads are harmless. But this is an erroneous opinion. What are their disadvantages?

During active walking, the pads are crushed or move to the side. There is discomfort in the process of using this hygiene product. Allergic reactions appear, unpleasant itching and irritation are felt. There is cystitis or thrush, an unpleasant odor.

Gaskets prevent you from leading an active lifestyle. A greenhouse effect is created, which contributes to infections penetrating deep into the cervix or remaining on the mucosa. Otherwise, the effect of using pads is quite acceptable during critical days.

Prevention of 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 menstruation, alternate the use of tampons with pads, take breaks.

Buy products with an absorbent capacity that will match the amount of bleeding. Change the product every 3-4 hours.

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

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

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

Sincerely, 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 the period of menstruation, you can wear tight clothes, play sports, dance, go to the pool and at the same time not feel any discomfort.

But many gynecologists oppose tampons. Some health problems are associated with their use: thrush, inflammation, dysbacteriosis. Tampon shock is the most dangerous ailment. How to avoid unpleasant consequences from the use of 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, always proceeds in an acute form.

It is important! You can't deal with toxic shock syndrome on your own. At the first symptoms of the disease, a woman is obliged to 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 are similar to the common flu:

increased body temperature (above 39 degrees);
jumps in blood pressure;
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 during menstruation occurs very quickly and is always acute. In the absence of the necessary 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. On the face of the patient there is perspiration, pallor of the skin. It comes to the point that a woman cannot be in an upright position, loses consciousness.
Increased body temperature (39-40 degrees).
Nausea, vomiting, loose, frothy stools.
Muscle pain, cramps.
Redness of the mucous membrane of the throat.
The occurrence of conjunctivitis, sour eyes.
Small amount of urine.
Swelling of the genitals.
Sharp pains in the lower abdomen and in the lumbar region.
Labored breathing.
For 4-5 days, red spots may appear on the skin, which are more reminiscent of burns.
On the 7-14th day, the skin on the palms and feet begins to peel off and peel off.
development of sepsis.
Damage to the liver, kidneys, central nervous system.

It is important! If, when using tampons, the stomach becomes very sick, the temperature rises, the pressure drops, immediately seek medical help. In 80% of cases, the doctor will diagnose: TSS. Do not wait for accompanying symptoms and deterioration. At the initial stage, toxic shock syndrome responds well to treatment, complications are extremely rare.

The specifics of the treatment of 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, if symptoms of TSS are detected, should be as follows:

Swab removal.
Airing the room so that there is access to oxygen.
Release from squeezing, closed clothing.
Bed rest.
Warm foot warmer.
Call an ambulance.

Syndrome prevention

Is it possible to avoid TSS when using tampons? As a preventive measure for 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 that, be sure to wash yourself with an intimate hygiene gel to restore the microflora of the vagina, 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 goods. If this component is present, then the risk of developing staphylococcal toxins increases dramatically.
If after using a tampon in the vagina there is itching, burning or redness, it is better to refuse these hygiene products.

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

Other names: toxic shock

Toxic shock syndrome (TSS) is a rare but serious infectious disease most commonly caused by the bacterium Staphylococcus aureus. 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 condition and in rare cases can lead to death.

The reasons

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 is a favorable culture medium for Staphylococcus aureus (Staphylococcus aureus). Thus, if blood stays too long in the vagina, 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 the use of tampons, but may occur after surgery or accidental injury.

Symptoms

Symptoms of toxic shock syndrome appear suddenly:

Confusion of consciousness, dizziness.
Great fatigue, weakness.
High temperature from 39°C to 40.5°C.
Headache.
Redness of the eyes, vagina.
Acute diarrhea, vomiting.
Sore throat.
Extensive rash accompanied by redness.

In the initial stage of the infection, flu-like symptoms (pain in the muscles, joints, throat, fever). Then red rashes appear. To this is added a violation of digestion (diarrhea, vomiting). Only after this shock is manifested by low blood pressure, tachycardia, confusion. After 1-2 weeks, the skin begins to flake off, especially on the palms and soles of the feet.

Diagnostics

To diagnose TSS, a clinical examination is required. Blood or tissue tests may be done to look for microorganisms. Other tests may be performed, such as an electrocardiogram, X-ray, computed tomography, or magnetic resonance imaging (MRI).

Treatment

If these symptoms occur, the first reflex is to remove the tampon or menstrual cup.

Second reflex: go to the hospital.

People suffering from toxic shock syndrome need 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 recurrence of the infection.

Prevention

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

During heavy periods, alternate between 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 multiple organ damage caused by exotoxins of Staphylococcus aureus or pyogenic streptococcus. Manifested by a sudden rise in temperature to 38.9 ° C or more, a drop in blood pressure, erythematous skin rashes followed by peeling, profuse diarrhea, vomiting, signs of damage to various organs and systems. The diagnosis of TSS is established on the basis of the clinical picture, physical examination data, laboratory, including bacteriological, analyzes. Treatment involves the sanitation of the bacterial focus, the appointment of 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 infection. Specialists in the field of gynecology encountered it two years later, noting the association of the development of the syndrome in young women with the use of superabsorbent hygienic tampons during menstruation. The vast majority of patients are women aged 17-30 years. Approximately half of them develop the syndrome associated with menstruation. In a quarter of cases of non-menstrual 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, surgeries with packing, 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 (Staphylococcus aureus) and pyogenic β-hemolytic group A streptococcus (Streptococcus pyogenes). In most cases, the disease does not occur at the time of primary infection with bacteria, but against the background of the carriage of infectious pathogens under the influence of the following predisposing factors:

Using tampons. The likelihood of developing TSS increases with the use of hygiene products with enhanced absorbent properties and violation of the recommended frequency of their replacement.
Use of intravaginal contraceptives. The presence of diaphragms, sponges, caps in the vagina creates favorable conditions for the reproduction of microorganisms.
Violation of the integrity of the mucous membranes. With injuries of the genital organs, the presence in the uterus of the remains of placental tissue, membranes, blood after childbirth and gynecological operations, optimal conditions arise for bacterial contamination and the penetration of microorganisms or their toxins into the blood.

Non-menstrual toxic shock syndrome can complicate surgical procedures in which a dressing is used that accumulates 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), taking 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 that promote the growth of bacteria and affect tissue permeability. The starting point is the penetration into the blood of significant amounts of specific toxins (TSST) and their interaction with T-lymphocytes. As a result, cytokines are massively released, causing a multi-organ toxic reaction. The vessels expand 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, edema occurs, coagulation is disturbed, and the temperature rises. Under the influence of mediated immune responses 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 menstruation. With 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, there is a prodrome in the form of general malaise, nausea, headache and muscle pain. The first sign of TSS is a severe chill with an increase in temperature to 39-40 ° C, after which a complete clinical picture unfolds within 1-4 days.

Almost all patients experience muscle weakness and diffuse muscle pain, especially in the muscles of the proximal limbs, abdominals and back. Often worried about pain in the joints. More than 90% of patients report persistent vomiting and profuse watery diarrhea, a scanty amount of urine. There is a sore throat, paresthesia, headache, photophobia, dizziness and fainting against the background of a drop in blood pressure. In some cases, coughing, pain when swallowing are disturbing. In the acute stage, lasting from 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 turn pale 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 patients develop severe itching on the 5-10th day 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 a primary manifestation or a 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 multi-organ 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:

Gynecological examination. Puffiness and hyperemia of the genital organs are revealed, in some cases - scanty discharge of a purulent nature from the cervical canal. Palpation can be determined by pain in the appendages.
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 mm Hg).
General clinical tests. KLA is characterized by leukocytosis with high neutrophilia, a shift of the leukocyte formula to the left, thrombocytopenia, anemia, and an increase in 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, and potassium.
Methods for determining the pathogen. To identify an infectious agent, a bacteriological swab 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, to exclude infectious diseases with a similar clinical picture.
Instrumental diagnostics. ECG allows timely detection of cardiac arrhythmias. Fluorography or chest x-ray are recommended to assess the condition of the lungs.

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

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

Infusion therapy. A key element of treatment is the restoration of intravascular fluid volume and the 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 the volume of intravascular fluid does not allow normalization of blood pressure, drugs with a pressor effect are administered.

With severe organ failure, the patient may be prescribed hemodialysis (with acute renal failure), artificial ventilation of the lungs with positive expiratory pressure (with respiratory distress syndrome). A number of authors note a faster recovery with the appointment of corticosteroids and immunoglobulins.

Forecast 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 mortality 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 erythrocytes is restored after 4-6 weeks. With streptococcal toxic shock, mortality is still high and reaches 50%. For the prevention of TSS, it is important to follow the recommendations for the use of tampons and the protocols for examination before childbirth and gynecological operations for the timely detection of pathogens.