Toxic shock syndrome (TSS) is an uncommon condition characterized by rash, fever, hypotension, desquamation of skin, and multisystem involvement. It occurs most commonly in menstruating women, estimated to afflict 9/100,000 per year, but it has been reported in nonmenstruating women and men as well. Toxin(s) producing strains of Staphylococcus aureus have been cultured from some body site in almost all cases. The Staphylococcus is presumed to be etiologic, although identical strains have been cultured from normal persons. The question raised by the two articles in the current issue of The Journal (pp 835 and 840) is whether tampon use enhances the risk of TSS among menstruating women who are vaginal carriers of S aureus. And if so, do Rely® brand tampons in particular further enhance this risk? (Rely brand tampons were voluntarily removed from the market on Sept 22, 1980, by the manufacturer, Procter and Gamble.)
The two articles
Hulka BS. Tampons and Toxic Shock Syndrome. JAMA. 1982;248(7):872–874. doi:10.1001/jama.1982.03330070060034
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