A mild case of toxic shock syndrome

The toxic shock syndrome (TSS) most often is seen in young, healthy women who become symptomatic during menstruation. The association between TSS and the use of tampons is strong. The symptoms usually begin suddenly and are often nonspecific. Prostration and hypotensive shock can occur within 24 hours. Milder forms of the disease also may be seen. The overall mortality rate is approximately 8 percent. This report describes a mild case of TSS in a young, healthy, 16-year-old female who developed symptoms during menstruation. She had been using regular-size tampons, which were changed frequently, but she did not change tampons during the night. A positive cervical culture for Staphylococcus aureus confirmed the diagnosis. The patient responded to supportive care and intravenous oxacillin. Her generalized maculopapular rash disappeared within 24 hours of admission, and her hands began to desquamate by the time of discharge. The patient was urged to avoid the use of tampons for four months subsequent to discharge.