Toxic Shock Syndrome

When toxic shock syndrome made headlines in the early 1980's, it quickly became known as a potentially fatal, rapid illness that struck women shortly after their menstrual periods. The infection was soon linked to use of certain high-absorbency tampons, which promote overgrowth of Staphlyococcus aureus bacteria already present in the vagina and which produce a toxin responsible for the symptoms.

Toxic shock syndrome is not unique to menstruating women. In fact, the first cases ever reported, which occured in 1978, involved children. Although only a few hundred cases of toxic shock syndrome are reported each year, it's important to know the symptoms, since it can develop—and become life-threatening—in a matter of hours.

HOW DOES TOXIC SHOCK SYNDROME DEVELOP?
The bacteria that cause toxic shock can sometimes colonize the skin surface, as well as the mucous membranes (such as the nasal passages and vagina) in perfectly healthy people. It is only when the microbe secretes a toxin that the disease begins. Researchers suspect that there might be more than one causative toxin. Besides use of superabsorbent tampons, deep wounds and surgery have been suggested as possible triggering factors.

WHEN SHOULD I SUSPECT THAT MY CHILD HAS TOXIC SHOCK SYNDROME?
Toxic shock syndrome beings abruptly, with a fever greater than 102 degrees Fahrenheit, vomiting and diarrhea. A sore throat, headache and muscle aches also may be present. Within 24 hours, a diffuse rash appears all over the body. Then, blood pressure drops, causing dizziness and a state of shock. In three percent of nonmenstrual cases, the drop in blood pressure is so severe that it is fatal.

With treatment, it typically takes about seven to ten days to recover from toxic shock syndrome, although the patient may not feel entirely normal again for about three more weeks. During the second week, the skin on the palms and soles often peels, and hair and nails sometimes fall out. In about 30 percent of cases, the disease recurs within three months of the original episode.

IS MEDICAL ATTENTION NECESSARY?
The three classic symptoms of toxic shock syndrome—high fever, vomiting and diarrhea—always demand medical attention.

HOW CAN THE PEDIATRICIAN TELL IF MY CHILD HAS TOXIC SHOCK SYNDROME?
Since toxic shock syndrome is far from the only possible cause of these symptoms, the doctor will need to rule out other serious disorders, such as septicemia (blood poisoning), Rocky Mountain spotted fever, scarlet fever, Kawasaki disease and measles. Toxic shock syndrome is distinguished from these other disorders by its wider range of symptoms. A diagnosis is made on the basis of the three classic symptoms, plus involvement of at least three organ systems, which may include the nervous system, digestive system, liver, kidneys, circulation, muscles and mucous membranes.

WHAT TREATMENTS ARE AVAILABLE?
Children and teenagers with toxic shock syndrome usually need hospitalization for management of low blood pressure and other complications of the disease. High doses of intravenous penicillin are administered for ten days.

PREVENTING TOXIC SHOCK SYNDROME

• Avoid packing the nasal passages with gauze to stop nosebleeds.

• Take care to keep deep cuts, burns and surgical incisions clean and disinfected.

Be aware of and alert to the symptoms of toxic shock syndrome, particularly if your child has recently had surgery or a deep wound. Seek medical assistance promptly.

RECOGNIZING TOXIC SHOCK SYNDROME
Your child may have toxic shock syndrome if he:

• Develops a sudden high fever (greater than 102 degrees Fahrenheit)

• Vomits

• Has diarrhea

• Develops a rash within 24 hours

• Is dizzy or faints, especially on standing

GETTING HELP
Call your doctor if your child:

• Suddenly develops a high fever, nausea and diarrhea

• Develops a widespread rash in the course of any flulike illness

Excerpt from THE DISNEY ENCYCLOPEDIA OF BABY & CHILD CARE, © 1995 DSH Communications, Inc. This material is based on current medical research and, to the best of the editors' knowledge and understanding, is accurate and valid. However the reader should not use information contained in this material to alter a medically prescribed regimen or as a form of self-treatment, without seeking the advice of a licensed physician.