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Encyclopedia > Toxic shock syndrome
Toxic shock syndrome
Classifications and external resources
ICD-10 A48.3
ICD-9 040.82

Toxic shock syndrome (TSS) is a rare but potentially fatal disease caused by a bacterial toxin. Different bacterial toxins may cause toxic shock syndrome, depending on the situation. The causative agent is Staphylococcus aureus. A similar condition, called Toxic Shock Like Syndrome (TSLS), is the result of Streptococcus pyogenes infection. TSLS is also referred to as Streptococcal TSS. The International Statistical Classification of Diseases and Related Health Problems (commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The following codes are used with International Statistical Classification of Diseases and Related Health Problems. ... // A00-A79 - Bacterial infections, and other intestinal infectious diseases, and STDs (A00-A09) Intestinal infectious diseases (A00) Cholera (A01) Typhoid and paratyphoid fevers (A010) Typhoid fever (A02) Other Salmonella infections (A03) Shigellosis (A04) Other bacterial intestinal infections (A040) Enteropathogenic Escherichia coli infection (A045) Campylobacter enteritis (A046) Enteritis due to Yersinia... The International Statistical Classification of Diseases and Related Health Problems (commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... A toxin, in a scientific context, is a biologically produced substance that causes injury to the health of a living thing on contact or absorption, typically by interacting with biological macromolecules such as enzymes and receptors. ... Phyla/Divisions Actinobacteria Aquificae Bacteroidetes/Chlorobi Chlamydiae/Verrucomicrobia Chloroflexi Chrysiogenetes Cyanobacteria Deferribacteres Deinococcus-Thermus Dictyoglomi Fibrobacteres/Acidobacteria Firmicutes Fusobacteria Gemmatimonadetes Nitrospirae Omnibacteria Planctomycetes Proteobacteria Spirochaetes Thermodesulfobacteria Thermomicrobia Thermotogae Bacteria (singular, bacterium) are a major group of living organisms. ... Binomial name Staphylococcus aureus Rosenbach 1884 Staphylococcus aureus (commonly called staph infection) is a spherical bacterium, frequently living on the skin or in the nose of a healthy person, that can cause illnesses ranging from minor skin infections (such as pimples, boils, and cellulitis) and abscesses, to life-threatening diseases... Binomial name Streptococcus pyogenes Rosenbach 1884 Streptococcus pyogenes is a Gram-positive bacterium that grows in pairs (diplococci) or short chains depending on the culture method. ...

Contents

Routes of infection

Infection can occur via the skin (e.g. cuts, surgery, burns), vagina (via tampon), or pharynx. In zootomy and dermatology, skin is an organ of the integumentary system made up of multiple layers of epithelial tissues that guard underlying muscles and organs. ... The vagina, (from Latin, literally sheath or scabbard ) is the tubular tract leading from the uterus to the exterior of the body in female placental mammals and marsupials, or to the cloaca in female birds, monotremes, and some reptiles. ... A tampon in the vagina A tampon with applicator The elements of a tampon with applicator. ... The pharynx (plural: pharynges) is the part of the neck and throat situated immediately posterior to the mouth and nasal cavity, and cranial to the esophagus, larynx, and trachea. ...


The number of reported toxic shock syndrome cases has decreased significantly in recent years. Approximately half the cases of TSS reported today are associated with tampon use during menstruation, usually in young women, though TSS also occurs in children, men, and non-menstruating women. In the US in 1997, only five confirmed menstrual-related TSS cases were reported, compared with 814 cases in 1980, according to data from the Centers for Disease Control and Prevention (CDC). [1] The menstrual cycle is the periodic change in a womans body that occurs every month between puberty and menopause and that relates to reproduction. ... The Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia, is recognized as the leading United States agency for protecting the public health and safety of people. ...


Although scientists have recognized an association between TSS and tampon use, no firm causal link has been established. Research conducted by the CDC suggested that use of some high absorbency tampons increased the risk of TSS in menstruating women. A few specific tampon designs and high absorbency tampon materials were also found to have some association with increased risk of TSS. It has been estimated that each year 1 to 17 of every 100,000 menstruating females will get TSS. [2] These products and materials are no longer used in tampons sold in the U.S. (The materials include polyester, carboxymethylcellulose and polyacrylate).[3] Tampons made with rayon do not appear to have a higher risk of TSS than cotton tampons of similar absorbency. SEM picture of a bend in a high surface area polyester fiber with a seven-lobed cross section Polyester is a category of polymers, or, more specifically condensation polymers, which contain the ester functional group in their main chain. ... Carboxymethyl cellulose, or CMC, is a cellulose derivative with carboxymethyl groups (-CH2-COOH) bound to some of the hydroxyl groups of the glucopyranose monomers that make up the cellulose backbone. ... The introduction to this article provides insufficient context for those unfamiliar with the subject matter. ... Rayon is a manufactured regenerated cellulosic fiber. ...


Vaginal dryness and ulcerations may occur when women use tampons more absorbent than needed for the amount of their menstrual flow. Ulcerations have also been reported in women using tampons between menstrual periods to try to control excessive vaginal discharge or abnormal bleeding. Women may avoid problems by choosing a tampon with the minimum absorbency needed to control menstrual flow and using tampons only during active menstruation. Alternately, women may use a silicone or latex rubber menstrual cup to avoid the negative side-effects of tampons. Vaginal lubrication is the naturally produced lubricating fluid that reduces friction during sexual intercourse. ... A menstrual cup is a type of cup or barrier worn by a woman inside her vagina during menstruation to collect menstrual fluid. ...


Rely tampons

This mostly comes through tampons boi! In 1975, Procter and Gamble introduced superabsorbent Rely tampons[4] , in response to women's demands for tampons which could contain an entire menstrual flow without leaking or replacement.[3] Rely used carboxymethylcellulose (CMC) and compressed beads of polyester for absorption. This tampon design could absorb nearly 20 times its own weight in fluid[5] . Further, the tampon would "blossom" into a cup shape in the vagina in order to hold menstrual fluids. Procter & Gamble Co. ... Rely was a brand of superabsorbent tampons made by Procter & Gamble starting in 1975. ... Carboxymethyl cellulose, or CMC, is a cellulose derivative with carboxymethyl groups (-CH2-COOH) bound to some of the hydroxyl groups of the glucopyranose monomers that make up the cellulose backbone. ... SEM picture of a bend in a high surface area polyester fiber with a seven-lobed cross section Polyester is a category of polymers, or, more specifically condensation polymers, which contain the ester functional group in their main chain. ...


The superabsorbent properties of Rely caused vaginal dryness by absorbing the natural humidity of the vagina. Often this led to ulcerations in the vaginal wall when the tampon was removed, offering pathways for bacteria to infect the bloodstream[5] . Further, the tampons' superabsorbency meant that the viscosity of vaginal fluids was enhanced, providing a good environment for bacteria growth[6] . In addition, CMC has features which effectively filter the toxins of Staphylococcus which cause TSS[5] . The recipe for disaster came about as a combination of S. aureus naturally benignly occurring in about 5–15% of women[7] , the insertion of the tampon adding oxygen to the normally anaerobic vaginal environment allowing for increased bacterial growth, and the tampon's super absorbency meant that women did not need to replace them as frequently and so left them in place longer. Humidity is the concentration of water vapor in the air. ...


According to the Boston Women's Health Book Collective, 942 women were diagnosed with tampon-related TSS in the USA from the March 1980 to March 1981, 40 of whom died.[6] In September 1980, Procter and Gamble recalled Rely[citation needed] after the Centers for Disease Control and Prevention released a report in mid 1980 explaining the bacterial mechanism which lead to TSS, and that Rely tampons was associated with TSS more than any other tampon. As part of the voluntary recall, Procter and Gamble entered into a consent agreement with the FDA "providing for a program for notification to consumers and retrieval of the product from the market".[8] The Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia, is recognized as the leading United States agency for protecting the public health and safety of people. ...


Symptoms and diagnosis

Symptoms of toxic shock syndrome vary depending on the underlying cause. In either case, diagnosis is based strictly upon CDC criteria modified in 1981 after the initial surge in tampon-associated infections.[1] TSS resultant of infection with the bacteria Staphylococcus aureus typically manifests in otherwise healthy individuals with high fever, accompanied by low blood pressure, malaise and confusion, which can rapidly progress to stupor, coma, and multi-organ failure. The characteristic rash, often seen early in the course of illness, resembles a sunburn, and can involve any region of the body, including the lips, mouth, eyes, palms and soles. In patients who survive the initial onslaught of the infection, the rash desquamates, or peels off, after 10–14 days. An analogue medical thermometer showing the temperature of 38. ... A sphygmomanometer, a device used for measuring blood pressure. ... Malaise is a term used to refer to a general state of discomfort, tiredness, or illness. ... Comatose redirects here. ...


In contrast, TSLS is caused by the bacteria Streptococcus pyogenes, and it typically presents in people with pre-existing skin infections with the bacteria. These individuals often experience severe pain at the site of the skin infection, followed by rapid progression of symptoms as described above for TSS. In contrast to TSS caused by Staphylococcus, Streptococcal TSS less often involves a sunburn-rash.


Diagnosis of TSS and TSLS are strictly based on CDC criteria; in general, the presence of high fevers, low blood pressure, confusion, and laboratory evidence of organ failure in the appropriate historical setting (e.g. menstruating woman using tampon, or young individual with pre-existing skin infection), are necessary to make the diagnosis.


Pathogenesis

In both Toxic shock syndrome (caused by S. aureus) and Toxic Shock-Like Syndrome (caused by S. pyogenes), disease progression stems from a superantigen toxin that allows the non-specific binding of MHC II with T-cell receptors, resulting in polyclonal T-cell activation.


Therapy

Women wearing a tampon at the onset of symptoms should remove it immediately. The severity of this disease results in hospitalisation for treatment. Antibiotic treatment consists of penicillin and clindamycin. For the Japanese rock band, see Penicillin (band). ... Clindamycin (rINN) (IPA: ) is a lincosamide antibiotic used in the treatment of infections caused by susceptible microorganisms. ...


One of the symptoms of toxic shock syndrome is extreme infection of the skin and deeper parts is called fasciitis necroticans (a.k.a. necrotizing fasciitis). It should be attacked surgically without delay. Necrotizing fasciitis is a serious but rare infection of the deeper layers of skin and subcutaneous tissues (fascia). ...


With proper treatment, patients usually recover in two to three weeks. The condition, however, can be fatal within hours. Some patients are admitted to the intensive care unit for supportive care in case of multiple organ failure. Intensive care medicine or critical care medicine is concerned with providing greater than ordinary medical care and observation to people in a critical or unstable condition. ... Multiple organ dysfunction syndrome - M.O.D.S. (previously known as multiple organ failure) is altered organ function in an acutely ill patient requiring medical intervention to maintain homeostasis. ...


See also

Necrotizing fasciitis or fasciitis necroticans, commonly known as flesh-eating bacteria, is a rare infection of the deeper layers of skin and subcutaneous tissues (fascia). ... Septic shock is a serious medical condition causing such effects as multiple organ failure and death in response to infection and sepsis. ...

References

  1. ^ Center for Devices and Radiological Health, U.S. Food and Drug Administration, Consumer information (Jul 23, 1999) Tampons and Asbestos, Dioxin, & Toxic Shock Syndrome PDF
  2. ^ Stayfree - FAQ About Toxic Shock Syndrome (TSS) (2006). Retrieved on 2006-10-13.
  3. ^ a b Citrinbaum, Joanna (Oct. 14, 2003). The question's absorbing: 'Are tampons little white lies?'. The Digital Collegian. Retrieved on 2006-03-20.
  4. ^ Finley, Harry. Rely Tampon: It Even Absorbed the Worry!. Museum of Menstruation. Retrieved on 2006-03-20.
  5. ^ a b c Vitale, Sidra (1997). Toxic Shock Syndrome. Web by Women, for Women. Retrieved on 2006-03-20.
  6. ^ a b Chapter 13, Toxic Shock Syndrome. Our Bodies, Ourselves. Boston Women's Health Book Collective, Inc. (2005). Retrieved on 2006-03-20.
  7. ^ Frederick, Jenn (2001). The Heath and Environmental Dangers of Traditional Menstural Products. The First Taboo: How Menstrual Taboos Reflect and Sustain Women's Internalized Oppression. Retrieved on 2006-03-20.
  8. ^ Kohen, Jamie (2001). The History and Regulation of Menstrual Tampons. RTF document. Retrieved on 2006-03-30.

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External links


  Results from FactBites:
 
Toxic Shock Syndrome- Health Encyclopedia and Reference (682 words)
Toxic Shock Syndrome (TSS) is a potentially fatal, flu-like disease caused by a toxin produced by a common strain of bacteria (staphylococci) that spreads to the bloodstream.
TSS is a condition that occurs in association with infections caused by the staphylococcus bacterium.
When toxic shock stems from a localized infection, such as an abscess or cellulitis, surgery is indicated to drain the abscess or debride devitalized tissues.
Toxic shock syndrome - Wikipedia, the free encyclopedia (928 words)
Toxic shock syndrome (TSS) is a rare but potentially fatal disease caused by a bacterial toxin.
Approximately half the cases of TSS reported today are associated with tampon use during menstruation, usually in young women, though TSS also occurs in children, men, and non-menstruating women.
Symptoms of toxic shock syndrome in the early phase can be hard to recognize because they mimic the flu.
  More results at FactBites »

 
 

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