Toxic shock syndrome (TSS) is a serious but uncommon bacterial infection. TSS was originally linked to the use of tampons, but it is now also known to be associated with the contraceptive sponge and diaphragm birth control methods. In rare cases, TSS has resulted from wounds or surgery incision where bacteria have been able to enter the body and cause the infection.

The symptoms of TSS include sudden high fever, a faint feeling, and watery diarrhea, headache, and muscle aches. If your child has these symptoms, it's important to call your child's doctor right away.

There are steps you can take to prevent TSS. Hand washing can play an important role in guarding against TSS. And if your daughter is just starting her menstrual period, she should understand what precautions she can take to prevent this infection.

There are actually two different types of this condition. Toxic shock syndrome, which is caused by Staphylococcus aurous bacteria, has been associated with the use of tampons. Although the exact connection is still not clear, researchers suspect that certain types of high-absorbency tampons provided a moist, warm home where the bacteria could thrive.

Although TSS usually occurs in menstruating women, it can affect anyone who has any type of staph infection (as skin infections, food poisoning, and endocarditis), including pneumonia, abscess, skin or wound infection, a blood infection called septicemia, or a bone infection called osteomyelitis.

A related infection, streptococcal toxic shock syndrome, or STSS, is caused by streptococcus bacteria. Most often STSS appears after streptococcus bacteria have invaded areas of injured skin, such as cuts and scrapes, surgical wounds, and even chickenpox blisters. It almost never follows a simple streptococcus throat infection (strep throat).

Symptoms

Toxic shock syndrome
Toxic shock syndrome from staphylococcus starts suddenly with vomiting, high fever, rapid drop in blood pressure, watery diarrhea, headache, sore throat, and muscle aches. Within 24 hours, a sunburn-like rash appears. There also may be bloodshot eyes and an unusual redness under the eyelids or inside the mouth (and vagina in females). After that, broken blood vessels may appear on the skin.

Streptococcal toxic shock syndrome (STSS)
Streptococcal toxic shock syndrome can happen following a streptococcus infection in the body, most often a skin infection or an infected wound. Within 48 hours of infection, the person's blood pressure drops dangerously low, and he or she may have fever, dizziness, confusion, difficulty breathing, and a weak and rapid pulse. The skin may be pale, cool, and moist, and there may be a blotchy rash that sometimes peels. The area around an infected wound can become swollen, red, and have areas of severely damaged or dying flesh. The liver and kidneys may begin to fail, and bleeding problems may develop.

Prevention

Females can reduce their risk of TSS by either avoiding tampons or alternating them with sanitary napkins. If a girl uses only tampons, it's important to choose tampons with the lowest absorbency that will handle her menstrual flow and to change the tampons frequently. Between menstrual periods, it's a good idea to store tampons away from heat and moisture (where bacteria can grow) - for example, in a bedroom rather than in a bathroom closet.

Because staphylococcus bacteria are often carried on dirty hands, it's important to wash your hands thoroughly before and after inserting a tampon. If your daughter is just starting her menstrual period, she should know about taking these precautions. Any female who has recovered from TSS should check with her doctor before using tampons again.

The best defense against STSS is to clean and bandage all skin wounds as quickly as possible. Call your doctor immediately whenever a wound becomes red, swollen, or tender, or if a fever begins. Although STSS almost never follows strep throat, it's wise to check with your doctor whenever your child has a sore throat with fever, particularly if your child's condition is worsening despite medical treatment.

As with TSS, doctors typically treat STSS with antibiotics and give intravenous fluids and medications to maintain normal blood pressure. Surgery is sometimes necessary to remove areas of dead skin and muscle around an infected wound.