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</div><div><span>Toxic shock syndrome</span></div></div>
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<article><div id="d-article"><div class="page-info"><div class="page-title"><a name="start" id="start">
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</a><h1 class="with-also" itemprop="name">Toxic shock syndrome</h1>
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</noscript></div><div class="main"><div id="ency_summary"><p>Toxic shock syndrome is a serious and potentially life-threatening disease that involves fever, <a test="test" href="./000039.htm">shock</a>, and problems with several body organs.</p></div><section><div class="section"><div class="section-header"><div class="section-title"><h2>Causes</h2></div><div class="section-button"><button type="submit" aria-controls="section-1" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-1"><p>Toxic shock syndrome is caused by a toxin produced by some types of staphylococcus bacteria. A similar problem, called toxic shock-like syndrome (TSLS), can be caused by a toxin from streptococcal bacteria. Very few staph or strep infections cause toxic shock syndrome.</p><p>The earliest cases of toxic shock syndrome involved women who used tampons during their menstrual periods. However, today less than one half of cases are linked to tampon use. Toxic shock syndrome can also occur with skin infections, burns, and after surgery. The condition can also affect children, postmenopausal women, and men.</p><p>Risk factors include:</p><ul><li>Recent childbirth</li><li>Infection with <em>Staphylococcus aureus</em> (<em>S aureus</em>), commonly called a staph infection</li><li>Foreign bodies or packings (such as those used to stop nosebleeds) inside the body</li><li>Recent surgery</li><li>Tampon use (with higher risk if you leave one in for a long time)</li><li>Wound infection after surgery </li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Symptoms</h2></div><div class="section-button"><button type="submit" aria-controls="section-2" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-2"><p>Symptoms include:</p><ul><li>Confusion</li><li>Diarrhea</li><li>General ill feeling</li><li>Headaches</li><li>High fever, sometimes accompanied by chills</li><li>Low blood pressure</li><li>Muscle aches</li><li>Nausea and vomiting</li><li>Organ failure (most often <a test="test" href="./000501.htm">kidneys</a> and liver)</li><li>Redness of eyes, mouth, throat</li><li>Seizures</li><li>Widespread red rash that looks like a sunburn -- skin peeling occurs 1 or 2 weeks after the rash, particularly on the palms of the hand or bottom of the feet </li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Exams and Tests</h2></div><div class="section-button"><button type="submit" aria-controls="section-3" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-3"><p>No single test can diagnose toxic shock syndrome.</p><p>The health care provider will look for the following factors:</p><ul><li>Fever</li><li>Low blood pressure</li><li>Rash that peels after 1 to 2 weeks</li><li>Problems with the function of at least 3 organs </li></ul><p>In some cases, blood cultures may be positive for growth of <em>S aureus </em>or <em>Streptococcus pyogenes</em>.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Treatment</h2></div><div class="section-button"><button type="submit" aria-controls="section-4" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-4"><p>Treatment includes:</p><ul><li>Removal of materials, such as tampons, vaginal sponges, or nasal packing</li><li>Drainage of infection sites (such as a surgical wound) </li></ul><p>The goal of treatment is to maintain important body functions. This may include:</p><ul><li>Antibiotics for any infection (may be given through an IV)</li><li>Dialysis (if severe kidney problems are present)</li><li>Fluids through a vein (IV)</li><li>Medicines to control blood pressure</li><li>Intravenous gamma globulin in severe cases</li><li>Staying in the hospital intensive care unit (ICU) for monitoring </li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Outlook (Prognosis)</h2></div><div class="section-button"><button type="submit" aria-controls="section-5" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-5"><p>Toxic shock syndrome may be deadly in up to 50% of cases. The condition may return in those who survive.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Possible Complications</h2></div><div class="section-button"><button type="submit" aria-controls="section-6" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-6"><p>Complications may include:</p><ul><li>Organ damage including kidney, <a test="test" href="./000158.htm">heart</a>, and liver failure</li><li>Shock</li><li>Death </li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>When to Contact a Medical Professional</h2></div><div class="section-button"><button type="submit" aria-controls="section-7" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-7"><p>Toxic shock syndrome is a medical emergency. Seek medical help right away if you develop a rash, fever, and feel ill, particularly during menstruation and tampon use or if you have had recent surgery.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Prevention</h2></div><div class="section-button"><button type="submit" aria-controls="section-8" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-8"><p>You can lower your risk for menstrual toxic shock syndrome by:</p><ul><li>Avoiding highly absorbent tampons</li><li>Changing tampons frequently (at least every 8 hours)</li><li>Only using tampons once in awhile during menstruation </li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Alternative Names</h2></div><div class="section-button"><button type="submit" aria-controls="section-Alt" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-Alt"><p>Staphylococcal toxic shock syndrome; Toxic shock-like syndrome; TSLS</p></div></div></section><section><div class="section sec-mb"><div class="section-header"><div class="section-title"><h2>Images</h2></div><div class="section-button"><button type="submit" aria-controls="section-tnails" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>References</h2></div><div class="section-button"><button type="submit" aria-controls="section-Ref" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-Ref"><p>Eckert LO, Lentz GM. Genital tract infections: vulva, vagina, cervix, toxic shock syndrome, endometritis, and salpingitis. In: Gershenson DM, Lentz GM, Valea FA, Lobo RA, eds. <em>Comprehensive Gynecology.</em> 8th ed. Philadelphia, PA: Elsevier; 2022:chap 23.</p><p>Kroshinsky D. Macular, papular, purpuric, vesiculobullous, and pustular diseases. In: Goldman L, Cooney KA, eds.<em> Goldman-Cecil Medicine.</em> 27th ed. Philadelphia, PA: Elsevier; 2024:chap 406.</p><p>Que Y-A, Moreillon P. Staphylococcus aureus (including staphylococcal toxic shock syndrome). In: Bennett JE, Dolin R, Blaser MJ, eds. <em>Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases.</em> 9th ed. Philadelphia, PA: Elsevier; 2020:chap 194.</p><p>Rapose A. Toxic shock syndrome. In: Kellerman RD, Rakel DP, Heidelbaugh JJ, Lee EM, eds. <em>Conn's Current Therapy 2024.</em> Philadelphia, PA: Elsevier 2024:718-719.</p></div></div></section>
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