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Introduction of toxic shock syndrome occurs mainly in the application of vaginal tampons in passing women. Because of the vaginal plug and the diaphragm of the role of publicity and some cotton in the market withdrawal of Serbian women in the sharp decline in the incidence of the disease. The lack of some of the symptoms of less serious cases are quite common, a small series of studies estimate the incidence of women walking about 3 / 100000, and those who do not have vaginal plugs after surgery and postpartum women and women are still case reports. Approximately 15% or as in the case of maternal postoperative staphylococcal wound infections, often without obvious clinical manifestations. and influenza-related cases of osteomyelitis, and cellulitis have been reported. etiology and pathogenesis of the exact cause of toxic shock syndrome unknown, but almost all cases were associated with phage group 1 of Staphylococcus aureus strains producing exotoxins related to the bacteria can produce toxic shock syndrome toxin -1 or the exotoxin. has been in the mucosal (nasopharyngeal, vaginal , trachea) or necrosis separate parts (empyema, abscess), and passing through the vagina of women found in such bacteria. It is reasoned that the existing colonies in the vagina and use the women's vaginal were the most dangerous toxic shock syndrome. is may be related with the vaginal plug mechanical or chemical factors have led to increased production of bacterial exotoxins, toxins can damage


the outer or uterine mucosa into the bloodstream. symptoms, signs and diagnosis of sudden onset, with persistent high fever (39 ~ 40.5 ), headache, sore throat, non-purulent conjunctivitis, deep lethargy, intermittent blurred consciousness without focal neurological signs, vomiting, profuse watery diarrhea and diffuse sun-like erythroderma. This syndrome can be in the 48 hours to progress to orthostatic hypotension, syncope, shock and death. after the onset of 3 and between the 7th day, the skin may occur and result in skin stripping off the debris and found especially in the skin of the palms and soles. other organs are also often involved, can cause mild non-hemolytic anemia, mainly by immature myeloid white blood cells increased in moderate and early thrombocytopenia and subsequent thrombocytosis. Although clinically significant bleeding rarely occurs, but thrombin the original time and partial thromboplastin time, there are extended orientation. 1 week of the disease, often can be found in liver function test abnormalities (hepatitis) and rhabdomyolysis. cardiopulmonary involvement may also occur, manifested as peripheral edema and pulmonary edema (abnormal central venous pressure low, suggesting that adult respiratory distress syndrome), in particular, severe hypotension can occur in children and physically inadequate blood perfusion, and almost all renal dysfunction, characterized by reduced urine excretion and blood urea nitrogen and creatinine increase. Toxic shock syndrome similar to the Kawasaki syndrome (mucocutaneous lymph node syndrome), but can be identified based on clinical manifestations. Kawasaki syndrome generally occurs in children under 5 years old, does not cause shock, azotemia or thrombocytopenia, rash as the spot papules. other identification should also be considered with scarlet fever, Reye syndrome, staphylococcal scalded skin syndrome, meningitis, bacteremia, Rocky Mountain spotted fever, leptospirosis and viral rash illness. These disease, according to the specific clinical manifestations, culture and serological tests to be eliminated. prognosis, prevention and treatment of this disease the mortality rate of 8% to 15%, but this data is only obtained by the basis of severe cases. whether the change of antibiotics acute course of the disease is not clear. the continued application of the vaginal plug the women after the first attack during the first 4 months of recurrence is very common. In the acute stage can be eliminated with antibiotics staphylococcus lesions to prevent recurrence. In addition to the eradication of gold aureus, but no other positive ways to prevent the exact (primary prevention or secondary prevention). but seriously, advised women not to use throughout the menstrual vaginal plug, which may be intermittent use sanitary napkins or other hygiene measures. suspect diagnosed patients with toxic shock syndrome should be immediately hospitalized and intensive treatment. immediately withdraw the vaginal plug, diaphragm or other foreign matter. must be fluid and electrolytes to prevent and treat hypovolemia, hypotension, or shock. Because the loss of fluid can be widely to the body tissue, shock may be a deep and stubborn, so sometimes require a lot of fluid and electrolytes. from mucosal surfaces and blood specimens were taken for Gram stain and culture; derived after -lactamase-resistant penicillin or cephalosporin bacterial enzyme hormone therapy.


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