Clinical Manifestations of Toxic Shock Syndrome

    August 1981 in “ JAMA ”
    P. Joan Chesney, Jeffrey P. Davis, W K Purdy, Philip J. Wand, Russell W. Chesney
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    TLDR Toxic Shock Syndrome mainly affects menstruating women, can recur, and is linked to staph bacteria, with rapid treatment being crucial.
    Between 1977 and 1980, a study of 22 women aged 13 to 44 hospitalized with Toxic Shock Syndrome (TSS) in Madison, Wisconsin, found that the disease primarily affected menstruating women and could recur. The patients, who all recovered, showed a range of symptoms including vocal cord paralysis, impaired finger sensation, and hair and nail loss during late convalescence. Cultures indicated that coagulase-positive staphylococci were present in the majority of those tested. Treatment involved antibiotics, intravenous fluids, and in some cases, additional support such as dopamine, steroids, or hemodialysis. The study highlighted the role of staphylococci in TSS, particularly in relation to tampon use, and suggested that the pathogenesis involved massive vasodilatation and fluid movement. It also noted that the severity of TSS might not correlate with the type or duration of antimicrobial therapy, and emphasized the importance of rapid treatment including tampon removal and fluid administration. The study was supported by grants and involved contributions from various medical staff and researchers.
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