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Toxic Shock Syndrome

Toxic Shock Syndrome (TSS)

This is a rare, but life-threatening infection caused by either Staph or Strep bacteria. The exotoxin it releases acts as a superantigen, causing a huge immune response, leading to shock and multi-organ failure.


This is often associated with super-absorbable tampon use in young women.


Risk factors:

  • Tampon use – Particularly when left in for an extended period of time, or are super-absorbent

  • Female barrier contraceptive i.e. diaphragm or cap

  • Childbirth

  • Break in skin

  • Pre-existing staph or strep infection e.g. strep throat, impetigo, cellulitis


Presentation

  • Symptoms start suddenly and get worse very quickly

  • Initial flu-like symptoms w/nausea, vomiting, and diarrhoea

  • Rapid progression to high-grade fever and widespread, macular rash

  • Multi-organ failure, w/hypotension and confusion


Investigations

  • Sepsis 6

  • Swabs of suspected initial site of infection


Management

  • Urgent admission

  • A-E assessment

  • Manage as appropriate



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