Toxic shock syndrome

There are two types of Toxic Shock Syndrome: The first (TSS), identified in 1978, is caused by the bacteria Staphylococcus aureus (staph). The second (STSS) and more recent discovery, is caused by a Group A Streptococcus(strep) bacteria. Although both are rare, both can be fatal. When eitherthe staph or strep bacterium enter a wound, their growth causes a poison--ortoxin, which enters the blood stream. Once this toxin enters the nervous system, it causes headaches, confusion, a drastic drop in blood pressure, and perhaps unconsciousness. Ultimately, the body goes into shock. Signs of shock include cold hands and feet; cool, moist skin; shortness of breath; rapid breathing; and anxiety. The toxin may also invade the heart or kidneys. Symptoms, which differ slightly between the two syndromes, begin suddenly and can be treated with antibiotics; shock may be treated with intravenous fluids, and medication to correct blood pressure.

TSS was identified in 1978 in relation to the use of tampons during menstruation, although anyone is susceptible to TSS if their immune system is unable to fight off staph invasion through an infected wound. The majority ofwomen affected by tampon use are under the age of 30 and primarily between the ages of 15 and 19, 98% of cases occur in white women, and the death rate isabout 6% of reported cases. This syndrome begins when the staph bacterium enter the system through the vagina--perhaps through a scratch from a tampon applicator. Highly absorbent tampons, particularly those containing rayon, appear to encourage the breeding of germs and thus increase the risk of TSS. Symptoms, which appear suddenly, may include a fever above 102 degrees Fahrenheit, a sunburn-like rash, peeling skin from the palms and soles, low blood pressure, vomiting or diarrhea, confusion or other mental changes, fatigue,thirst, and rapid breathing. Some women who have recovered from TSS have reported subsequent hair loss, loss of limbs, paralysis, and miscarriages; some people experience recurrence of the syndrome. Experts advise changingthe tampon every four to six hours, alternating between sanitary napkins andtampons, ceasing the use of tampons in the presence of thrush, vaginal cuts or sores, or if vaginosis was present within the preceding year, avoiding tampons containing rayon, and paying particular attention to cleanliness. In theUnited States, TSS affects approximately 17 people in 100,000 and about 200 people per year.

STSS, a severe illness which proves fatal in more than 50% of cases, developswhen the strep bacteria enters a cut, wound, surgical incision, or even chickenpox blisters. Seldom does strep throat cause STSS, however. Symptoms are similar to TSS, and the area surrounding the wound becomes red and swollen andsometimes necrotic (begins to die). STSS, classified as an "emerging" illness and related to the strain of strep called "flesh-eating bacteria," is reported in only one or two out of every 100,000 people in the U.S. As thisinfection is still not well understood, prevention advice focuses on thoroughly cleansing and covering the wound with a bandage as quickly as possible. Medical advice should be sought immediately wound becomes red or swollen, or with the onset of fever.

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