Bacteria
Julius P. Kreier in Infection, Resistance, and Immunity, 2022
Toxic shock syndrome is caused by a toxin released by certain strains of Staphylococcus aureus that contain a lysogenic phage. Although the syndrome has been associated with use of tampons, it also occurs with infection wi th S. aureus at other sites, especially in surgical wounds. The syndrome is essentially an intoxication as the organism grows in some isolated site and elaborates toxin there. The disease occurs when the toxin diffuses into the surrounding tissues; the organisms seldom invade the tissue however. The condition assumed prominence with the introduction of a new type of highly absorbent tampons. These tampons were sufficiently absorbent that they did not need changing for many hours. The prolonged retention of the blood and secretion soaked tampon provided opportunity for the organisms to grow and elaborate toxin. Surgical wounds also provide sites for microbial growth, for example, around stitches or in gauze or other types of drains which remain in the wounds for fairly long periods.
Toxic shock syndrome
Biju Vasudevan, Rajesh Verma in Dermatological Emergencies, 2019
The origins of this lethal disease date back to 1978, when pediatric case reports started flowing into the Centers for Disease Control and Prevention regarding this novel entity. Toxic shock syndrome (TSS) was first described as a febrile, bacterial toxin-mediated, hyperacute, multiorgan system disease with mucocutaneous manifestations. The next few years saw a surge in the cases of toxic shock syndrome among menstruating women, ascribed to the usage of superabsorbent tampons. In recent times, with the advent of cotton and rayon-based tampons, the incidence of menstrual TSS has gone down drastically. However, TSS continues to be reported across all age groups and sexes, owing to cutaneous and aural infections, gynecological and surgical procedures, and as a sequelae to burns [1,2].
Genital hygiene
Miranda A. Farage, Howard I. Maibach in The Vulva, 2017
The principal health concern related to tampon use is its association with menstrual toxic shock syndrome (TSS). TSS is a rare but recognizable and treatable disease (see Table 36.3 for signs and symptoms) (63). Women aged 15–24 years are the highest-risk group for menstrual TSS, with adolescents making up a significant proportion of cases (64,65). The reported incidence of menstrual TSS peaked in the early 1980s and has since declined significantly (65). All tampons are associated with a low risk of menstrual TSS; the risk is independent of chemical composition per se, but increases with tampon absorbency (66). Other hygiene practices, such as bathing frequency, douching, and use of feminine deodorants, are not associated with menstrual TSS risk (67).
Pathophysiological Considerations in Periorbital Necrotizing Fasciitis: A Case Report
Published in Ocular Immunology and Inflammation, 2023
Yalda Hadizamani, Stefano Anastasi, Anouk Schori, Rudolf Lucas, Justus G. Garweg, Jürg Hamacher
Risk factors increasing susceptibility to develop NF include diabetes mellitus, chronic renal failure, cardiovascular disease, drug abuse and alcoholism.2,3,8,43,44 The patient’s general condition, risk factors and underlying comorbidities as well as pathogenic virulence factors determine the outcome of NF. Around 45% of patients with arterial hypotension and streptococcal-induced toxic shock syndrome develop acute respiratory distress syndrome.45 Morbidity and mortality of the Streptococcus-induced toxic shock syndrome are higher than for the Staphylococcus-induced toxic shock syndrome and are in a range of 30–80%.45,46 Patients who have neutralizing antibodies against superantigens are less likely to develop NF.37 If superantigens however enter the bloodstream of patients devoid of neutralizing antibodies from previous exposures, they can trigger a sudden, significant and non-specific T cell stimulation and consequently a cytokine storm,37 resulting in systemic toxicity, multi-organ failure and septic shock.38,47 The Streptococcus-induced toxic shock syndrome can present with locally invasive Streptococcal infections such as pharyngitis or more violent diffuse disorders like arthritis, bacteremia, endocarditis, meningitis, pneumonia, sinusitis, cellulitis, myositis and necrotizing fasciitis.48
A Comparison of the Menstrual Cup and the Intrauterine Device: Attitudes and Future Intentions
Published in Women's Reproductive Health, 2019
Jessica M. Milne, Jessica L. Barnack-Tavlaris
The menstrual cup is an alternative to the more commonly used pads and tampons. Tampons and pads are the norm in many countries around the world including, but not limited to, the U.S., U.K., France, and Germany (NonWovens Industry, 2016). In one study conducted with a national U.S. sample, researchers found that 62% of women reported use of pads, and 42% reported use of tampons (percentages include women who reported using both products; Branch, Woodruff, Mitro, & Zota, 2015). Although pads and tampons are the more popular products, they are not without physical, financial, and environmental drawbacks. For instance, because tampons are absorbent, they can deprive the body of fluids needed to maintain a regular pH level and, in rare cases, can cause toxic shock syndrome (TSS; DeVries et al., 2011). A study of surveillance data in the U.S. state of Minnesota revealed an annual menstrual TSS incidence rate of 1.41 per 100,000 among girls and women aged 13 to 24 (.69 were menstrual cases in women of all age groups; DeVries et al., 2011). In addition, a significant amount of money is spent each year (e.g., a personal average of $120 USD) on pads and tampons, and the disposable nature of these products has a negative impact on landfills (Schumacher, 2014).
Persistent Streptococcus pyogenes infection of the forearm following blunt trauma
Published in Case Reports in Plastic Surgery and Hand Surgery, 2020
Erin M. Cravez, Adam Y. Nasreddine, Andrea Halim
Infectious disease and orthopedic surgery were consulted. His compilation of symptoms were concerning for toxic shock syndrome. LRINEC score was calculated to be 7 given the lab work summarized in Table 1. After discussion with the family regarding his forearm as a potential source of infection, he underwent an MRI with contrast which demonstrated diffuse subcutaneous edema in the forearm and bony edema in the proximal ulna, possibly consistent with his recent checking injury. Radiology felt there was no evidence of myositis or necrotizing fasciitis. After completion of 24 h of IV antibiotics, his abdominal complaints improved but he had minimal systemic improvement and increasing erythema of the arm as well as a new vesicular rash on the medial left arm (Figure 2). After discussion with the patient and his parents, he was taken emergently to the operating room for irrigation and debridement of the left forearm approximately 36 h after hospital presentation.