infectious diseases
Toxic Shock Syndrome (TSS)
Staphylococcal toxic shock
People athighest risk of staphylococcal TSSare Women who have preexisting staphylococcal colonization of the vagina and who leave tampons or other devices (eg, menstrual cups, cervical caps, intrauterine devices, contraceptive sponges, diaphragms, pessaries) in the vagina Mechanical or chemical factors related to tampon use probably enhance production of the exotoxin or facilitate its entry into the bloodstream through a mucosal break or via the uterus. Estimates suggest about 3 cases/100,000 menstruating women still occur, and cases are still reported in women who do not use tampons and in women who have infection after childbirth, abortion, or surgery. About 15% of cases occur postpartum or as a complication of postoperative staphylococcal wound infections that appear insignificant. Staphylococcal TSS has also been reported in both men and women with any type ofS. aureusinfection. Recurrences are common among women who continue to use tampons and other devices during the first 4 months after an episode ( Reference ). Mortality resulting from staphylococcal TSS is<3%. 