Toxic Shock Syndrome

Question 1

What is toxic shock syndrome?

Answer 1

• Septicaemia and multisystem inflammatory response from toxin produced by staphylococcus and streptococcus bacteria
  
  • Staphylococcus → exotoxins (e.g. TSS toxin 1)
  • Streptococcus → inflammatory cascade initiation

Question 2

What are the risk factors for toxic shock syndrome?

Answer 2

• Tampons of higher absorbency
• Infrequent change of tampons
• Overnight tampon use

Question 3

What are the signs and symptoms of toxic shock syndrome?

Answer 3

• Fever (usually >39C)
• Myalgia
• Diffuse red macular rash
• D&V
• Sore throat
• Headache
• Desquamation of palms and soles
• Shock

Question 4

What are the suspected investigations for toxic shock syndrome?

Answer 4

• Bloods
  
  • FBC - raised WCC, low platelets
  • U&Es - impaired renal function
  • LFT
  • Raised CK
  • Raised CRP
• Microbiology
  
  • HVS
  • Blood culture
  • Culture of tampon

Question 5

What is the management of toxic shock syndrome?

Answer 5

• ABC
• Remove tampon
• Antibiotics

Question 6

What are the complications of toxic shock syndrome?

Answer 6

• Septic shock
• MOF
• DIC
• ARDS
• Death - mortality is 5-15%