Toxic-Shock Syndrome Not Associated With Menstruation

Al, Reingold; Bb, Dan; Kn, Shands; Cv, Broome

doi:10.1016/s0140-6736(82)92552-1

Cited by 256 publications

(34 citation statements)

References 11 publications

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“…1"" 1 6 The mortality of TSF is unknown but is likely to be similar to the presently reported 5% for TSS.' Both diseases can occur following skin infections' 4,17 although TSF most commonly occurs as a complication of pharyngitis/tonsillitis' -4 and TSS in association with vaginitis during menstruation following tampon use.5-10 The other clinical features that would suggest TSF in cases of uncertainty include puncta and skin crease accentuation of the erythema (Pastia's sign). Illness in a male would also suggest TSF in a disease that has an equal sex incidence, whereas TSS has a 9:1 female predominance.…”

Section: Discussionmentioning

confidence: 99%

Scarlet fever can mimic toxic shock syndrome

Brook

Bannister²

1988

Postgraduate Medical Journal

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Summary:We describe a patient who presented with a widespread erythematous rash, diarrhoea, confusion, pre-renal uraemia and hyponatraemia. The diagnosis of staphylococcal toxic shock syndrome seemed likely as she was menstruating and there was no evidence of pharyngitis. A rising ASO titre confirmed a streptococcal aetiology and thus 'toxic' scarlet fever. Toxic shock syndrome and toxic scarlet fever are compared.

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Section: Discussionmentioning

confidence: 99%

Scarlet fever can mimic toxic shock syndrome

Brook

Bannister²

1988

Postgraduate Medical Journal

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“…Although the mean age is higher and the ratio of males to females closer to that in the general population, the clinical findings and complications are the same as those of the patients with menstrual TSS (63). The number of confirmed cases reported in children under ten years is surprisingly low (62). Nonmenstrual cases have been associated with nonsur gical cutaneous and subcutaneous infections (30%), childbirth or abortion (27%), infections following a wide variety of surgical procedures (18%) including gauze packing of a nasal cavity, vaginal infections occuring at times other than during menses or the postpartum interval or following the use of a diaphragm (5%), and other or unknown sources of infection (20%) (63).…”

Section: Nonmenstrual Tss and Associated Risk Factorsmentioning

confidence: 94%

The Disease Spectrum, Epidemiology, and Etiology of Toxic-Shock Syndrome

Chesney¹,

Bergdoll²,

Davis³

et al. 1984

Annu. Rev. Microbiol.

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From this composite picture of the history and recent developments related to TSS, several points are clear. TSS is not a new disease, and TST-producing strains of S. aureus are not new. What is new is the recent dramatic increase of this disease in young women who use tampons during menses and who lack antibody to TST. What is also new is the recognition that the disease commonly recurs but only in menstrually associated cases. What remains to be determined are the precise role of tampons, the factors leading to toxin induction, and the mechanism of action of this potent toxin. In order to better determine what these factors and mechanism of action are, and to determine if the TST marker protein is in fact the critical toxin, a reliable animal model is badly needed. Finally, a reliable laboratory test to confirm the clinical diagnosis is another high-priority need. The further unraveling of the secrets of this complex disease may greatly enhance our understanding of the disease associated with this toxin, of the intricacies of toxin production by other bacteria, and of the role that exogenous cofactors play in disease processes.

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“…TSS is classified as either menstruation-associated or nonmenstruation-associated [268,269]. TSST-1 is the only SAg associated with menstrual TSS (mTSS) most likely due to its ability to cross the mucosa [270].…”

Section: Staphylococcal Tssmentioning

confidence: 99%