Toxic Shock
From Encyclopedia of Sex and Sexuality
In the early 1980s the emergence of a virulent type of infection, sometimes fatal, was associated with women’s use of tampons. Labelled toxic shock syndrome, the illness, which attacked many vital organs, resulted from the release of a toxin in infections caused by a strain of bacterial called the coagulase positive staphylococcus.
The disease was distinctive, with fever, low blood pressure, and involvement of the skin (initial reddening and later peeling) particularly of the palms of the hand and soles of the feet. There was a multisystem involvement that sometimes included three or more of the following: gastrointestinal muscular, mucous membranes, kidney, liver, blood (decreased platelet counts), and the central nervous system. In these patients the coagulase positive staphylococcus could frequently be isolated from the primary site of infection, usually the vagina, but the organism did not invade the blood steam.
As the disease reached epidemic proportions in the early 1980s, some distinctive characteristics were noted. Ninety percent of toxic shock syndrome (TSS) victims were women, most under the age of thirty-four, and the onset of their symptoms occurred either during the menstrual period or immediately afterward, TSS was also four times more common in North Central and Mountain States than in Mid- or South Atlantic States. The association of TSS with tampon use was noted from the earliest reports and users of super-absorbent tampons that remain in the vagina for the longest period of time were at the greatest risk.
The removal of super-absorbent tampons from the market markedly reduced, but did not totally eliminate, TSS. Any body infection with this strain of bacteria, for example an abdominal wound infection after an operation, can result in toxic shock syndrome.
Antibiotics such as penicillin and cephalosporin are effective against this organism and corticosteroids help obviate the effects of the toxin on body organ systems. Recently, a syndrome identical to TSS in clinical presentation and laboratory abnormalities has been reported in patients with an infection from another form of bacteria called the group. A beta hemolytic streptococcus. A review of case reports of infections caused by this bacteria in the 1960s and 1970s suggest this syndrome was already noted then although not recognized as such. These infections, however, are very rare. The group A beta hemolytic streptococcus can be killed by a variety of antibiotics, and organ system changes can be obviated by medical care.
TSS is a serious problem for the patient involved, but fortunately it is a rare event in the 1990s.
