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Sara Manitoski was found dead during a study trip to Vancouver Island, Canada. On the morning of her death, Sara's friends came out of the cabin where they were staying, thinking that she was still sleeping. When they returned, the young woman was in the same position and completely motionless.
Colleagues called the emergency services, but the young woman finally did not resist the toxic shock syndrome.
The autopsy confirmed medical suspicion: the girl died of a toxic shock syndrome (STC), caused by staphylococcus aureus found in a tampon inside the body [19659004] Rare but potentially fatal disease
TSC is a rare but potentially life-threatening disease that attracted public attention in 1980, when 812 cases described among tampon users. She came back to the fore in 2012 when model Lauren Wasser cut her right leg because of this syndrome.
According to Elsa Milheiras, a specialist in gynecology / obstetrics, there are two bacteria that can cause this disease: Staphylococcus aureus present on the skin and mucous membranes of 30 to 50% of adults and children in good condition health (nostrils, skin, vagina and rectum), and Streptococcus pyogenes .
The strains of Staphylococcus aureus concerned are those that produce the TSST -1 or toxin toxic shock syndrome and enterotoxin B. These exotoxins are superantigens, since they activate simultaneously large amounts of immune cells, T cells, resulting in massive production of substances responsible for the signs and symptoms of the syndrome
. in 1979-1980, menstrual cases accounted for the overwhelming majority (91%), currently only about half, estimated at one in 100,000 women. The use of tampons continues to be a contributing factor. risk, especially those who are at increased risk of bleeding, and the use of tampons is still a risk factor.
Absorption ability. It is for this reason that brands provide information brochures recommending such instructions as changing the cap every 4 to 8 hours, using the appropriate minimum absorption degree, not to mention the intravaginal tampons and preferably wear sanitary napkins during the night. In the absence of treatment, STC easily evolves into gangrene, a type of necrosis caused by death of body tissue due to lack of blood and lack of oxygen (hypoxia).
This is not reversible and requires limb amputation. affected. However, the CTS can have other causes, occurring at all ages and in 25% of cases it reaches the males.
The disease also results from surgical wound infections and childbirth and also after mastitis, septorhinoplasty. (19659002) The main signs and symptoms include: fever at or above 38.9 ° C, hypotension and skin manifestations (erythroderma), inflammation of the skin, diffuse and posterior desquamation). Clinical manifestations occur quickly, usually within the first two days after the onset of menses.
Clinical manifestations occur rapidly, usually within the first two days after the onset of menses. or after surgery. Toxic shock syndrome involves at least three systems but can target all organs and systems: gastrointestinal, including liver, muscles, urinary tract, hematologic (anemia, coagulation disorders), central nervous system, respiratory system and circulatory, including the heart.
Whenever a toxic shock syndrome is suspected in a patient, the vaginal canal must be screened and any tampon that may be present must be removed.
Treatment is based on the replacement of fluids (10 to 20 liters of intravenous fluids per day) and vasoconstrictors to counteract severe hypotension, ensuring organ perfusion. Intravenous antibiotics for one to two weeks eradicate the bacteria and prevent recurrences by eliminating the carrier state.
Death by toxic shock syndrome usually occurs in the first days after hospitalization and is often due to treatment-resistant cardiac arrhythmias. , cardiomyopathy, irreversible respiratory failure and, rarely, bleeding caused by coagulation abnormalities.
The mortality rate is, in ascending order, 1.8% in menstrual cases, 3-5% in children, 5-6% in non-menstrual cases and 30-70% if the bacterium responsible is Streptococcus pyogenes .
The immunity of populations contributes to the rarity of the disease, since, in the fourth decade of life, more than 90% of people have antibodies against TSST-1 (toxic shock syndrome toxin). However, their absence may also justify the severity of the syndrome in some individuals, as many patients with the disease do not even have these antibodies nor develop them after their recovery.
Do not create immunity, leave an open door to new episodes of the disease. This is one of the reasons why women with a previous episode of toxic shock syndrome associated with tampons should no longer be used
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