Recurrent Menstrual Toxic Shock Syndrome

 

Features of persistent menstrual toxic shock syndrome:

(1) repeated episodes of TSS or persistent signs and symptoms

(2) persistent colonization with Staphylococcus sureus

(3) production of toxin by the Staphylococcus aureus

(4) failure to develop neutralizing antibody to the toxin (failure to develop a humoral immune response)

 

Differential diagnosis:

(1) multiple exposures to different toxigenic strains of Staphylococcus aureus (recognition requires analysis of culture isolates)

 

A patient with recurrent Staphylococcal TSS:

(1) should not use tampons

(2) should be treated with anti-staphylococcal antibiotics until the toxigenic strain is cleared