Medicines for Toxic shock syndrome

What it is

Toxic shock syndrome (TSS) is a rare but very serious, life-threatening condition caused by toxins produced by certain bacteria (usually types of staphylococcus or streptococcus). It comes on suddenly and can rapidly make a person very unwell, affecting multiple parts of the body, so it is a medical emergency that needs immediate treatment. TSS has been particularly associated with tampon use (especially leaving a tampon in for a long time, or using high-absorbency tampons), but it can affect anyone — including men, children, and women who are not menstruating — and can develop from other sources of infection, such as skin wounds, burns, infections after surgery or childbirth, or other infections. The symptoms of TSS come on suddenly and can include: a sudden high temperature (fever); a widespread rash that looks like sunburn; feeling or being sick, or diarrhoea; a very low blood pressure, which can cause feeling faint, dizzy, or confused; muscle aches; and, as it progresses, signs of the body becoming seriously unwell, including confusion and collapse; peeling of the skin (particularly on the palms and soles) can occur later. Because TSS is life-threatening and progresses rapidly, it is a medical emergency: anyone with a sudden high fever, a sunburn-like rash, and feeling very unwell — particularly if using a tampon, or with a wound or infection — needs immediate medical help. If TSS is suspected and a tampon is in place, it should be removed. Treatment is in hospital, usually in intensive care, and includes antibiotics, treatment to support the blood pressure and organs, removing the source of infection, and other supportive care. With prompt treatment, people can recover, though TSS is serious. Reducing the risk (for example using tampons safely — changing them regularly, using the lowest suitable absorbency, and not leaving them in too long — and good wound care) is worthwhile. The key message is to seek immediate medical help for the combination of sudden high fever, a sunburn-like rash, and feeling very unwell.

How it is treated

Toxic shock syndrome is a medical emergency and is treated urgently in hospital, often in intensive care, because it is life-threatening and progresses rapidly. If TSS is suspected — a sudden high fever, a widespread sunburn-like rash, feeling very unwell, with symptoms such as vomiting, diarrhoea, muscle aches, dizziness or faintness (from low blood pressure), or confusion, particularly in someone using a tampon or with a wound or infection — immediate medical help (emergency services) is essential. As a first step, if a tampon is in place, it should be removed. In hospital, treatment is urgent and usually includes: antibiotics to treat the bacterial infection, given into a vein; treatment to support the blood pressure and circulation (such as fluids and other measures), as low blood pressure is a key danger; supporting the organs and treating complications, which may require intensive care; and removing or treating the source of infection (for example a wound infection, or removing a tampon or other source). Other treatments may be used depending on the situation. Because TSS is rapidly progressive and serious, prompt recognition and treatment are critical to the outcome. Recovery depends on how quickly treatment is started and how severe the illness is; with prompt treatment, people can recover, though TSS is serious and can be fatal or cause complications. Reducing the risk is worthwhile: using tampons safely — changing them regularly (as advised), using the lowest absorbency suitable for your flow, alternating with other sanitary products, washing hands before and after insertion, and not leaving a tampon in for longer than recommended; using barrier contraceptives (such as diaphragms or caps) as directed; and practising good wound care and hygiene. People who have had TSS before are advised to avoid tampons and certain products, as it can recur. The key message is recognition and urgency: the combination of a sudden high fever, a sunburn-like rash, and feeling very unwell is a medical emergency needing immediate help — remove a tampon if one is in place, and call for emergency help. The reassuring message is that, although TSS is rare and serious, prompt emergency treatment can be life-saving, and simple measures reduce the risk.