What is Toxic Shock Syndrome?
Toxic shock syndrome (TSS) is a severely life-threatening bacterial infection named by Todd equal to 1978. It is caused by toxins released by bacteria (mainly Staphylococcus aureus and Streptococcus), and is caused by shock and viscera. Acute disease characterized by organ failure. Generally believed to occur in menstrual women, the pathogenic bacteria is Staphylococcus aureus (staphylococcus aureus).
Basic Information
- English name
- toxic shock syndrome
- Visiting department
- Internal medicine
- Common causes
- Staphylococcal enterotoxin F and pyrogenic exotoxin C
- Common symptoms
- Chills, fever, general muscle pain, nausea, vomiting, diarrhea, etc.
Causes of toxic shock syndrome
- Toxic shock syndrome is caused by virion produced by phage type staphylococcus aureus, namely staphylococcal enterotoxin F and pyrogenic exotoxin C. Recent studies have shown that the activity and structure of these two toxins are the same.
- This disease is more common in young women during menstruation, and is related to the use of vaginal plugs during menstruation. Vaginal plugs that contaminate Staphylococcus aureus multiply under menstrual blood and an appropriate temperature to produce phage type S. aureus. At the same time, vaginal plugs can cause mucosal dryness and epithelial changes, which are conducive to the absorption of toxins. Non-menstrual women, men, and children can also cause Staphylococcus aureus through wound hematoma or gauze packing to cause the disease.
Clinical manifestations of toxic shock syndrome
- Women with toxic shock syndrome have an incubation period of 1 to 2 days, manifested as sudden onset, chills, fever, general muscle pain, nausea, vomiting, and diarrhea. Systemic congestive rash and hypotension may occur on the second day of the disease. In severe cases, multiple organ failure may soon occur, manifesting as cyanosis, dyspnea, low partial oxygen pressure, oliguria, elevated urea nitrogen, and conscious coma.
Toxic shock syndrome test
- At present, there is no specific detection method. The white blood cell count, C-reactive protein, and procalcitonin can be determined for the patients to be diagnosed. It can be used for blood, vaginal secretions, vaginal plug bacterial culture + drug sensitivity. Blood gas and liver and kidney function can be measured in the failure of lung, kidney, liver and other organs. If there is a tendency for hemorrhage and a rapid decrease in platelets, tests such as prothrombin, 3P test, EDP fibrin degradation products, and euglobulin dissolution time are needed to determine whether disseminated intravascular coagulation (DIC) has occurred.
Diagnosis of toxic shock syndrome
- The main criteria (standards) for diagnosing TSS are acute fever, scarlet fever-like rash, progressive peeling of fingertips, toes, palms, and soles of feet, hypotension characterized by orthostatic dizziness or syncope, or significant shock. Additional diagnostic evidence is evidence of involvement of more than 3 organs or systems, such as blood, gastrointestinal, neurological, cardiovascular, liver, kidney, or muscle organs or systems.
Treatment of toxic shock syndrome
- Stable vital signs
- This includes breathing, circulatory support, oxygen inhalation, ECG monitoring, and venous access. Tracheal intubation is required in patients with pulmonary failure.
- 2. Remove the source of infection
- Check for foreign bodies in your body and remove them (such as tampons, female condoms, drainage strips, or nasal stuffing). Find infections (such as surgical incisions or skin infections), and surgically remove infected skin and necrotic tissue.
- 3. Anti-infective treatment
- Initially, nafcillin (neopenicillin III), oxacillin (neopenicillin II), penicillin, and / or clindamycin can be used. Adjust after blood culture and drug sensitivity results are available.
- 4. Anti-shock and supportive care
- Scientific liquid treatment, rational application of vasoactive drugs glucocorticoids, correction of acid-base balance and electrolyte disorders.
Toxic shock syndrome prevention
- Women during menstrual period should avoid using tampons with high adsorption capacity. They can use tampons with low adsorption force and replace them every 4-6 hours. Use sanitary napkins whenever possible. Wash your hands before and after changing tampons. Sanitary napkins and tampons should be stored in a dry place, not in a cool and humid bathroom. Don't put two tampons at one time. Replace with new tampons before going to bed. The stuffing and drainage strips in the body should be replaced in time to avoid skin damage. At the same time, the skin should be clean and hygienic to prevent infection.
- Toxic shock syndrome is dangerous and has a high mortality rate, so early detection, early diagnosis and early treatment must be done to prevent the disease from developing.