Talk:Toxic shock syndrome

Wiki Education Foundation-supported course assignment
This article was the subject of a Wiki Education Foundation-supported course assignment, between 1 July 2019 and 23 August 2019. Further details are available on the course page. Student editor(s): Mquindoy, Docwoods12, Dchnggg, Xmrlmem. Peer reviewers: Zaccarlson, Nzargham.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 11:33, 17 January 2022 (UTC)

Original version
The original version of this article was taken from the public domain U.S. FDA document at http://www.fda.gov/cdrh/consumer/tamponsabs.html Please revise as necessary. — Preceding unsigned comment added by Karada (talk • contribs) 23:08, 1 December 2003 (UTC)

Why tampons?
Is it possible to go into detail as to WHY tampons and leaving sanitary products (pads, cups) for a significant amount of time could case TSS? I heard it was caused by toxins in the synthetic materials used, and it would not happen from washable cloth pads (or cups but i've read otherwise) But it says in the article it is caused by bacteria on the skin.. this doesn't make sense. Does it mean that when a woman is menstuating there could be a build up of this bacteria if she doesn't change often enough, and that it will travel up inside her to cause TSS. — Preceding unsigned comment added by 82.41.85.24 (talk) 20:15, 19 September 2005 (UTC)
 * (Toxic shock syndrome in this case is caused because the tmapon soaks up so well in that area that it disrupts the vaginal microbe community 'good bacteria'. There is lots of bacteria in the vagina (and gut actually) that help protect the body by acting as a barrier for harmful bacteria so this is probably wrong --->)bacteria are always on the skin, tampons being left in provide a good breeding ground, essentially a warm blood soaked cloth with pockets of O2 for aerobic bacteria and pokects without o2 for anaerobic bacteria, and also as the rely tampon sections should can cause ulcers providing the bacteria with a way in, it also removes the natural "fluids" and secretions form the vagina whihc help inhibit bacteria growth this can lead to infection. Wolfmankurd 15:34, 22 February 2007 (UTC)
 * The authors of the early studies of menstrual TSS hypothesized that the ulcerations caused by superabsorbent tampons could be involved, but there has been no evidence produced since then to support this hypothesis. The TSST-1 toxin is capable of crossing the vaginal wall into the bloodstream without ulcerations being present.  Additionally, the bacteria are almost never found in the bloodstream of women suffering from menstrual TSS.  I have removed the statement, which appeared in two places, that ulcers provide a way for bacteria and toxin into the blood from the vagina.  I also moved the description of the "oxygen theory" from the History to the Routes of Infection section.  NighthawkJ 04:16, 14 April 2007 (UTC)
 * Sometimes controversial to state (nothing to cite as all the research is looking the other way), but TSS is linked with menstruation (blood), not just tampons. Common-sense reasons why it might have come to be associated with tampons:
 * research/diagnosis done in countries where tampons are widely used (are there stats on this?)
 * cross-contamination of bacteria on e.g. skin directly to the inside of the vagina, rather than the inside of knickers


 * Additionally:
 * the closed-off breeding ground and damage to the vaginal wall arguments as above may have something to do with it, in which case menstrual cups would have lower risk as they don't disintegrate or swell.


 * The sentence: "Alternately, a woman may choose to use a different kind of menstrual product that may eliminate or reduce the risk of TSS, such as sanitary napkins or a menstrual cup" is ... a bit precocious considering we do not know why some people develop menstrual TSS. I'm leaving it in for now as it spreads the word about menstrual cups. However it should be taken into account that the lack of TSS association with menstrual cups is as likely to be due to the smaller pool of women who use them compared to tampons. I would class the risk highest to lowest: tampons, menstrual cup, sanitary towels, nothing (but IANAD).
 * Njál 14:10, 8 May 2007 (UTC)

Vandalism removal
I removed "You are all Schmogs" from the article. — Preceding unsigned comment added by 69.177.103.34 (talk) 19:16, 8 May 2006 (UTC)

Cause
In the article, it says it can be caused by bacteria on the skin because there is ALWAYS bacteria living on your skin, at any given time. There are forms of S. aureus, etc., but not all bacteria is necessarily bad. — Preceding unsigned comment added by 70.170.59.189 (talk) 06:12, 12 May 2006 (UTC)

Barrier contraceptives
Okay, does anyone know why Barrier contraceptives (i.e silicone/rubber cups) are linked to causing TSS, but menstrual cups (also silicone cups) are not supposed to be risk factor for TSS?? There seems to be a logical inconsistency here. --75.34.48.18 20:32, 23 October 2006 (UTC)
 * Can you cite your source for silicone/rubber contraceptives being linked to TSS, and describe them, too? I don't know what sort of contraceptive you're talking about. Njál 22:29, 25 October 2006 (UTC)

Therapy
Re-added the therapy section as it was rmeoved but the header remained so i assum eit was an accident.Wolfmankurd —Preceding undated comment added 15:36, 22 February 2007 (UTC)

Incorporation of text
Someone may like to incorporate U of M researchers find new, more effective treatment for toxic shock syndrometo the Therapy section. angela26 23:48, 21 May 2007 (UTC)

What the...
I realise this must be a silly question, but this is a stupid article. It provides an in-depth look at the symptoms, without actually saying what TSS is. Wikipedia is an encyclopedia, and should be written so it can be understood by someone reading with no background information, not copied off a tampon instruction leaflet.

Also, the first paragraph is grossly inconsistant, and makes little sense. —Preceding unsigned comment added by Metagraph (talk • contribs) 11:14, 27 April 2008 (UTC)


 * I agree this article is not useful. TSS is a common outcome of post operative infection, and "in 1997, only five confirmed menstrual-related TSS cases were reported" so why does the entire article talk about tampons?


 * It needs to have like any other disease more about symptoms, treatment, diagnosis, pathology, and causes. The whole article is practically about causes, focussing on the minor area of tampons.  —Preceding unsigned comment added by 118.138.198.145 (talk) 07:59, 11 May 2008 (UTC)

Question in Rely segment
In the segment on Rely, it says that the tampons were created to hold an entire menstrual flow. This seems unlikely, and the article cited doesn't actually say this about Rely. Whoever is working on this, please confirm and/or check your sources. Thank you. Clockster (talk) 20:49, 9 August 2008 (UTC)


 * Rely used to have a website talking about the tampons and the recall for some reason somewhere.. I can't find it at the moment, but I distinctly remember it discussing how to could hold an entire menstrual cycle's worth of fluid. Maybe it's on the packaging, of which a picture is available on the article? 96.238.115.21 (talk) 14:03, 21 February 2009 (UTC)

Tampons Being Lost
...showed cases of TSS after Tampons were either left in or lost inside of the woman.'

Can we remove the bolded bit? First of all, it is completely impossible to "lose" something inside your vagina. It's not like a tampon can enter through the vagina and make it's way into your stomach; there's a small pocket that items inserted into the vagina can sometimes makes it's way into, making it difficult to retrieve, but tampons are far too big for that anyway. Read about the [vagina]] if you're interested. And further, telling women that TSS cases that were linked to tampon use were due to tampons being lost inside of the woman is going to cause unnecessary panic. 96.238.115.21 (talk) 14:03, 21 February 2009 (UTC)

Review
In Lancet Infectious Diseases: Fvasconcellos (t·c) 14:26, 19 May 2009 (UTC) Ow, My Face. —Preceding unsigned comment added by 91.105.80.236 (talk) 18:34, 2 February 2011 (UTC)

Why so much emphasis on menstruation?
someone sotr it out. There are hundreds of other causes of TSS, why are we just focusing on the cause that has made headlines in the United States.. when will you americans realise you are not the only country on the Earth? — Preceding unsigned comment added by 139.184.30.134 (talk) 23:44, 25 May 2010 (UTC)

Signs and symptoms - is this right or are the bacterium swapped here?
I am not a medical expert but have read somewhat on the subject of Streptococcus pyogenes. The second paragraph of the Wikipedia article on S. pyogenes under the subheading "Pathogenesis" reads:

"Infections due to certain strains of S. pyogenes can be associated with the release of  bacterial toxins. Throat infections associated with release of certain toxins lead to   scarlet fever. Other toxigenic S. pyogenes infections may lead to streptococcal toxic   shock syndrome, which can be life-threatening.[1]"

Then look up the article on scarlet fever (caused by S. pyogenes) and you will find that the signs and symptoms for scarlet fever are very similar if not the same as that described here for TSS resulting from Staphylococcus aureus while the signs and symptoms described here for TSS resulting from S. pyogenes are those usually associated with Staphylococcus aureus. To my mind the Staph. aureus is usually a skin infection and the S. pyogenes is a throat infection. I may be in error as I'm not a medical expert and due to same I am reluctant to edit the article.

I wonder if someone expert in this field of medicine would be kind enough to take a look at the article and edit it (as necessary) for us.

Oddbod1 (talk) 04:29, 6 November 2011 (UTC)

Causes section
The Causes section is absurd making this one of the most embarrassing articles in Wiki, it needs desperate help from someone knowledgeable to correctly outline the causes, treatment prognosis etc. TSS can be caused by about a thousand different kinds of injury and hygene practice.... someone get on the ball jeez (Anuoldman (talk) 13:49, 18 July 2012 (UTC)).

Woefully inadequate
there is a current event regarding a TSS death from a playground wound and this article is woefully inadequate... there needs to be urgent attention from an expert to address the wide range of causes and rewrite the entire article to correctly document causes and effects other than vaginal infection..... (Anuoldman (talk) 16:01, 18 July 2012 (UTC)).

Agreed. A nurse I saw at a hospital to didn’t even know Strep. TSS was a thing. Nobody is told about it. There is a higher mortality rate for Strep. TSS (probably because nobody hears about it). I know its rare, but it’s dangerous. Thanks! Maddielily0910 (talk) 21:09, 6 July 2019 (UTC)

Review
Short review from Intensive Care Medicine 10.1007/s00134-015-3861-7 JFW &#124; T@lk  09:14, 7 September 2015 (UTC)

Is the DIAGNOSIS section needed?
Should the Diagnosis section be removed because it is already covered in Signs and symptoms, or should the latter be split? I vote for the former.

Jalegris (talk) 01:16, 29 September 2017 (UTC)
 * Diagnostic criteria typically belong in the diagnosis section. I have split. Doc James  (talk · contribs · email) 06:15, 29 September 2017 (UTC)

Treatment
Treatment section could use a face lift. Currently it says a combo of penicillins and cephalosporins and vancomycin. And then clinda might help or something. But we can do better than that. Like any emergency bacterial infection, there's two steps. First it's treated empirically and then based on cultures. From other sources online, it appears that they give clindamycin or linezolid and then add vancomycin or daptomycin or ceftaroline until cultures come back (merk manual). And then of course there's the above link to something about of V-beta which I don't know if it's clinically done yet. — Preceding unsigned comment added by 2607:FEA8:3C20:111A:8960:D2F3:FDF5:10B (talk) 14:44, 30 August 2018 (UTC)

Foundations 2 2019, Group 8b goals
The following are potential improvements to the article that could be made for our class assignment.
 * 1. There are microorganisms other than S. aureus and Strep. pyogenes that can cause shock syndrome; these other organisms can be documented.
 * 2. Although mentioned in the Treatment section, volume resuscitation to counteract hypotension could be added to the lead section.
 * 3. None of the statements in the Signs and symptoms section have any references; they all need to be substantiated.
 * 4. Only one of the statements in the Pathophysiology section has a reference; the rest of the statements need to be substantiated.
 * Xmrlmem (talk) 05:48, 1 August 2019 (UTC)


 * Added an a sentence identifying the seasonality and bimodal age distribution traits of TSS. Also, I ran into a date issue with the automatic citation feature; can a more experienced Wikipedian please help out with the issue's resolution?

Xmrlmem (talk) 05:09, 2 August 2019 (UTC)
 * That was fixed (not by me). I've also removed the URL from the ref ... it's not helpful to link to URL's that don't contain freely accessible full text; just type the DOI or PMID into the citation. I did use Citation bot to add a PMID though. Graham 87 14:44, 2 August 2019 (UTC)


 * Added citations using Gottlieb et al. for many of the statements in the Signs and symptoms section. Also added used Wilkens et al. to substantiate a statement in the Pathophysiology section regarding T-cell mediated cytokine storming.

Xmrlmem (talk) 16:44, 3 August 2019 (UTC)

Foundations II Group 8a Peer Review, Zachary
1. Do the group’s edits substantially improve the article as described in the Wikipedia peer review “Guiding framework”? Yes, the group's edits substantially improve the article. They add and clarify information regarding causes of toxic shock syndrome, and added important references.

2.Has the group achieved its overall goals for improvement? The group addressed all of their goals.

3. Are the edits formatted consistent with Wikipedia’s manual of style? If not, specify… Yes, all of the group's edits follow the Wikipedia's manual of style.

Zaccarlson (talk) 21:20, 5 August 2019 (UTC)

Group 8a Peer Review, Terry
Yes, the group added specific bacterial species that are involved in TSS and expanded the treatment options. A suggestion is to expand on "volume resuscitation" mentioned in the beginning overview. This can be done in the "Treatment" section of the contents. Yes, the group had specific goals that were achieved, such as adding microorganisms involved in TSS and the bimodal distribution of TSS ages. Yes, this draft is free of bias language and represents a very neutral point of view. Each edit is supported by secondary sources. Terry.vo (talk) 17:24, 6 August 2019 (UTC)
 * 1) Do the group’s edits substantially improve the article as described in the Wikipedia peer review “Guiding framework”?
 * 1) Has the group achieved its overall goals for improvement?
 * 1) Does the draft submission reflect a neutral point of view? If not, specify…

Foundations II Group 8a Peer Review, Nadia
1. Do the group’s edits substantially improve the article as described in the Wikipedia peer review “Guiding framework”?

Yes, the edits on various bacteria types that cause Toxic Shock Syndrome improved a key aspect of the article.

2. Has the group achieved its overall goals for improvement?

Yes, they achieved all of their goals successfully.

3. Does the draft submission reflect a neutral point of view? If not, specify…

Yes, the tone is neutral and offers non-biased information from appropriate sources.

Nzargham (talk) 17:24, 6 August 2019 (UTC)

Foundations II Group 8a Peer Review, Jane
The group met most of their goals in adding in more references for their listed topics (i.e. signs and symptoms, as well as adding in more information about different types of bacteria that cause TSS. It would be nice to see greater exploration of treatments for complications like hypotension and shock. References were cited appropriately from secondary sources. Language is also neutral and unbiased.

Jiangyad (talk) 18:25, 6 August 2019 (UTC)

New text
For this article I added in information I felt was important and useful to be added. I added the section ways of contraction, complications and prevention methods. I also added information about how TSS does not only occur in women. It can affect any gender and age group. Lastly, I added some information about the history of TSS. Xlbdc (talk) 22:53, 2 April 2022 (UTC)

Japanese Epidemic
This disease seems to be spreading rapidly in Japan at the moment, is info about this needed to be added? Username900122 (talk) 07:42, 21 June 2024 (UTC)
 * If info was to be added it would go in, but as with the separation of COVID-19 and COVID-19 pandemic, it should probably be its own article if notable, with a link here.  11:47, 21 June 2024 (UTC)
 * It was added to the "Notable cases" section but I removed it, partly because I felt it was out-of-place there. After reading this discussion I put it back in the "Epidemiology" section, where it seems to fit better. Graham87 (talk) 17:42, 21 June 2024 (UTC)
 * I've tweaked it a bit further. Graham87 (talk) 17:53, 21 June 2024 (UTC)
 * The nature of this article falls outside my confident zone, but the current reference seems a little less than great to me. Other news sources have covered the story and ABC has a decent alternative which could provide more for our WP:SUMMARY:   22:14, 21 June 2024 (UTC)
 * Ditto, this article is only on my watchlist due to vandalism that stayed around for a while. I thought I'd added the Washington Post source as well last night my time; turns out I did but I put it in the wrong place. I've just moved it and swapped out the old ref with the yours. Graham87 (talk) 06:53, 22 June 2024 (UTC)
 * Yeah, I can't remember exactly why I came here in the first place, but apparently fixed a typo and got attached :)  16:45, 22 June 2024 (UTC)