Sudden development of rash in palms and soles accompanied by fever, changes in mental status with renal or respiratory failure indicates onset of TSS. In addition, affected individuals would also exhibit signs of diarrhea, nausea, headache, low blood pressure, seizures, muscle aches, vomiting and development of redness in the eyes, throat and mouth.

The rash that develops often appears like sun burns followed by skin peeling and occurs after a period of 1 to 2 weeks. The common sites of rash development are the palms and area beneath the feet.

Signs and symptoms of TSS often develop suddenly indicating quick and prompt medical intervention. Failure to initiate immediate treatment can cause debilitating complications to set in [7].

No single test would be helpful in diagnosing TSS. A series and combination of methods needs to be employed for appropriately diagnosing the condition. The following methods are carried out for diagnosis:

• Blood tests to determine complete blood count which would reveal leukocytosis in individuals who have developed TSS. In addition, blood cultures are carried out to determine the presence of bacteria.
• Urine analysis is done to evaluate presence of myoglobinuria and hemoglobinuria.
• Imaging studies such as CT scan and chest X-ray are also indicated to determine the functioning of various organs [8].

The primary and major goal of treatment of TSS is to restore the vital functioning of the organs of the body. Individuals may need to be hospitalized until the vital signs are under control. This would be achieved by administration of antibiotics through the intravenous route to ward off the infections. Of lately, FDA approved 3 antibiotics to be used for treatment of TSS. These include tedizolid, dalbavancin and oritavancin. These drugs are known to be active against species of Staphylococcus aureus and Streptococcus [8]. Other medications would also be employed to stabilize the patient and bring the blood pressure back to normal levels. Intravenous fluids are also administered to correct dehydration. If complications have already set in such as kidney failure then dialysis is indicated in such cases.

If the syndrome is caused due to foreign agents such as tampons or vaginal sponge, then preliminary the foreign matter would be removed. If wound from injury are cause of infection, then surgical debridement of the infected tissue is indicated. Individuals are also given gamma globulin injections which help in boosting the immunity status of the affected individuals [9] [10].

The onset of the symptoms of TSS is pretty quick and turns fatal in about 50% of cases. Early recognition of the signs of the syndrome is very important to prevent the onset of complications. Individuals who survive the condition can suffer from recurrent attacks of the syndrome.

In many instances, TSS can severely affect the functioning of various organs such as kidney, liver and heart. The development of shock due to toxin production by the bacteria can severely impair the physical and mental functioning of the affected individuals [6].

TSS can affect individuals of any age group. It is primarily caused due to toxins produced by the Staphylococcus aureus. Individuals with infections of the skin, burns, open wounds and surgery are more susceptible to contract toxic shock syndrome. The toxin producing variety of Staphylococcus aureus often target the population who are at risk of developing the syndrome [2].

TSS is a rare condition and its incidence underwent significant decline after 1980. However, rise in number of cases of TSS was reported in the year 2000. It has been estimated that the syndrome occurs in about 3 to 4 out of every 100,000 users of tampons per year [3].

For the bacterial toxins to produce effect and cause development of characteristic symptoms, the causative organism must gain entry inside the body. Once infection occurs, the bacteria produce toxins which are systemically absorbed by the human body. Manifestations of signs and symptoms of TSS occur in those individuals who do not have antitoxin antibody protective layer. Such sequence of events causes production of cytokines which in turn induce tissue injury and shock [4] [5].

Use of high absorbent tampons has a significant association with TSS. Women are therefore advised to take a careful note of this fact and discontinue the use of such tampons. Low absorbent tampons should be preferred as these should be changed every 4 to 8 hours. Prolonged usage of such absorbent tampons can increase the risk of developing TSS. Individuals who have suffered wounds or injury are advised to regularly check their wounds for signs of infection. Regular cleaning of the wound is also expected [11].

Toxic shock syndrome (TSS) can affect menstruating women as well as men and children. The condition was first described in the year 1978 in children. Research studies have pointed towards an association between use of tampons and development of TSS in menstruating women. However, the incidence of TSS has decreased in this population owing to withdrawal of highly absorbent tampons from the market.

Definition

Toxic shock syndrome (TSS) is a life threatening condition caused by bacterial infections. In the past, TSS was associated with use of highly absorbent tampons by menstruating women. However, individuals who have suffered injuries are also susceptible to develop such a kind of syndrome.

Cause

In majority of the cases, TSS is caused due to toxins produced by the bacteria Staphylococcus aureus. In many instances, a streptococcus bacteria is also responsible for causing TSS.

Symptoms

Symptoms of TSS develop suddenly and the disease progresses at a fast pace. The signs include high fever, headaches, hypotension, vomiting and diarrhea, muscle aches, confusion, seizures and rash on palm and soles.

Diagnosis

Blood and urine tests are required for diagnosis of TSS. Blood cultures will provide information regarding the type of bacteria present. In addition, imaging tests would be necessary to evaluate the function of the vital organs of the body.

Treatment

Individuals with TSS will need to be hospitalized to be closely monitored for the vital signs. In addition, antibiotics are administered for warding off the infection from the body. Foreign bodies such as tampons are the cause of infection then these are removed. If wounds are the cause then surgical debridement of the tissues would be necessary.

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