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December 28, 1984

Prevention and Treatment of Toxic Shock Syndrome: A Retrospective Look

JAMA. 1984;252(24):3411-3412. doi:10.1001/jama.1984.03350240057042

Five years ago, the medical community was first notified of the sudden emergence of what appeared to be a new and extraordinary illness.1 Since that time, the Centers for Disease Control has received reports of more than 2,500 cases of what we now know as "toxic shock syndrome" (TSS).

Investigations quickly uncovered that TSS had a peculiar predilection for young women during their menses and that recurrences of the illness arose in subsequent menstrual periods.2 Studies of the menstrually associated cases demonstrated that the disease in these women was associated with the use of tampons and with vaginal infection with Staphylococcus aureus.3

Despite its recent recognition, descriptions of staphylococcal illnesses indistinguishable from TSS have appeared for more than 50 years.4-7 Studies of nonmenstrual TSS have shown that these cases too are associated with staphylococcal infection.8,9 The vast majority of all recovered TSS staphylococcal isolates are

 Toxic-shock syndrome—United States .  MMWR 1980;29:229-230.
 Follow-up on toxic-shock syndrome—United States .  MMWR 1980;29:297-299.
Shands KN, Schmid GP, Dan BB, et al:  Toxic-shock syndrome in menstruating women—association with tampon use and Staphylococcus aureus and clinical features in 52 cases .  N Engl J Med 1980;303:1436-1442.Crossref
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Aranow H Jr, Wood WB:  Staphylococcal infection simulating scarlet fever .  JAMA 1942;119:1491-1495.Crossref
Dunnet WN, Schallibaum EM:  Scarlet-fever-like illness due to staphylococcal infection .  Lancet 1960;2:1227-1229.Crossref
McCloskey RV:  Scarlet fever and necrotizing fasciitis caused by coagulase-positive hemolytic Staphylococcus aureus, phage type 85 .  Ann Intern Med 1973;78:85-87.Crossref
Reingold AL, Dan BB, Shands KN, et al:  Nonmenstrually associated cases of toxic-shock syndrome—a review of 54 cases .  Lancet 1982;1:1-4.Crossref
Reingold AL, Hargrett NT, Dan BB, et al:  Nonmenstrual toxic shock syndrome—a review of 130 cases .  Ann Intern Med 1982;96(pt (2) ):847-851.Crossref
Schlievert PM, Shands KN, Dan BB, et al:  Identification and characterization of an exotoxin from Staphylococcus aureus associated with toxic-shock syndrome .  J Infect Dis 1981;143:509-516.Crossref
Bergdoll MS, Crass BA, Reiser RF, et al:  A new staphylococcal enterotoxin, enterotoxin F, associated with toxic-shock syndrome Staphylococcus aureus isolates .  Lancet 1981;1:1017-1021.Crossref
Davis JP, Chesney PJ, Wand PJ, et al:  Toxic-shock syndrome: Epidemiologic features, recurrence, risk factors, and prevention .  N Engl J Med 1980;303:1429-1435.Crossref
 Follow-up on toxic-shock syndrome .  MMWR 1980;29:441-445.
 Toxic-shock syndrome—United States, 1970-1980 .  MMWR 1981;30:25-33.
Helgerson SD, Mallery BL, Foster LR:  Toxic shock syndrome in Oregon: Risk of recurrence .  JAMA 1984;252:3402-3404.Crossref
Shands KN, Dan BB, Schmid GP:  Toxic-shock syndrome: the emerging picture .  Ann Intern Med 1981;92:264-266.Crossref
Todd JK, Ressman M, Caston SA, et al:  Corticosteroid therapy for patients with toxic shock syndrome .  JAMA 1984;252:3399-3402.Crossref