Toxic shock

Toxic shock is extremely rare. However, in most cases it poses a serious risk to human health.

This phenomenon can develop quickly and lead to negative processes in various organ systems, including the lungs, kidneys and liver.

Causes of toxic shock

The causes of toxic shock are mostly related to bacterial infections. They produce toxins that lead to the development of toxic shock. They are quite common today, but usually do not cause serious harm to the body. They can lead to the development of throat or skin infections. All of this is easily eliminated and does not entail serious consequences. In rare cases, toxins enter the bloodstream and thus cause a strong immune reaction in people whose bodies do not fight them at all.

Streptococcal shock occurs during childbirth, flu, chickenpox and operations. It can develop against the background of minor cuts, wounds or bruises. Even the most common bruises that are not capable of damaging the integrity of the skin can cause its appearance.

Staphylococcal toxic shock occurs after prolonged use of tampons or after a surgical procedure. In many cases, it is almost impossible to prevent the development of this phenomenon.

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Pathogenesis of infectious toxic shock

Pathogenesis of infectious toxic shock - at the level of small vessels is characterized by the fact that a large number of toxins enter the circulatory system. They are secreted by saprophytic bacteria. This phenomenon leads to a sharp release of adrenaline and other biologically active substances. They can cause spasm of postcapillary venules and arterioles. Blood that circulates through the opened arteriovenous shunts cannot perform its direct function. Against this background, tissue ischemia and metabolic acidosis occur. Deterioration of circulation leads to tissue hypoxia, due to oxygen deficiency, anaerobic metabolism occurs.

At the level of organ systems, the pathogenesis of infectious toxic shock manifests itself in the form of blood deposition in capillaries and the release of its liquid part into the intercellular space. First, relative and then absolute hypovolemia occurs. A decrease in kidney perfusion is possible. This leads to an excessive drop in glomerular filtration. The edema developing against this background causes acute renal failure. Similar processes occur in the lungs. This is why toxic shock is quite dangerous.

Symptoms of toxic shock

Symptoms of toxic shock develop quickly and rapidly. Moreover, all this is so fleeting that death can occur within 2 days.

The first signs of the "disease" include extremely severe consequences. Thus, there are sensations that are similar to the flu. Muscle pain, stomach cramps, headache and sore throat begin. The temperature can suddenly rise to 38.9. Vomiting and diarrhea are possible.

Over time, signs of shock appear. They are characterized by low blood pressure and rapid heartbeat. Often all this is accompanied by dizziness, loss of consciousness, nausea, vomiting or dysphoria and clouding of consciousness. Redness, similar to sunburn, is possible. It can appear in several parts of the body or in separate places. Mostly, these are the armpits or groin. There is severe pain at the site of infection. Redness of the nasal passages and mouth is observed.

Other symptoms include: conjunctivitis, blood poisoning, peeling of skin tissue, and tissue death. This is why toxic shock is extremely dangerous for humans.

Infectious toxic shock

Infectious toxic shock is a sharp decrease in blood pressure. It occurs against the background of the negative impact of toxic substances produced by viruses or bacteria.

This type is often called septic shock, bacteriotoxic shock or endotoxic shock. It is an extremely non-specific clinical syndrome. It occurs mainly in a number of infectious diseases due to metabolic, neuroregulatory and hemodynamic disorders caused by bacteremia (viremia) and toxemia.

It often occurs against the background of meningococcal infection, flu, fever, typhoid and typhus, diphtheria, salmonellosis, dysentery and other dangerous infections. The mechanism of pathogenic disorders in this case is determined by the type of pathogen, the nature of the treatment, the intensity of the pathological processes occurring in the body (organ), their degree and other parameters. Toxic shock is a serious disorder in the body.

Toxic shock syndrome

Toxic shock syndrome is a relatively rare disease. It is characterized by a sharp onset. All this entails serious consequences for a person's life. This syndrome can progress quickly. Therefore, first aid measures must be taken immediately.

Toxic shock syndrome occurs against the background of infection with staphylococci and streptococci. Under normal conditions, they do not bother a person in any way. But under certain conditions, they are capable of releasing toxins that enter the bloodstream and lead to severe inflammatory reactions.

The immune system's reaction leads to phenomena that are characteristic of toxic shock syndrome. The streptococcal variety of the "disease" is typical in the postpartum period, with complications after an acute respiratory infection, and also with damage to the skin.

Staphylococcal syndrome appears due to a forgotten tampon in the vagina. Therefore, you need to monitor your own health more carefully. Because toxic shock is an extremely negative phenomenon for the body.

Toxic Shock from Tampons

Toxic shock from tampons can be caused by a staph infection. This is mainly due to a forgotten tampon in the vagina. The disease can progress quickly and lead to serious consequences. In some cases, it is not so easy to eliminate the negative symptoms, and sometimes it is simply impossible. The fatal outcome is observed in 8-16% of cases.

This syndrome often appears in women aged 15-30. Naturally, this is associated with the use of tampons during critical days. There have also been cases when the syndrome appeared in women who prefer vaginal contraceptives.

The development of the disease is provoked by Staphylococcus aureus. These microorganisms are always present in the oral cavity, nose, vagina and on the skin. Under unfavorable conditions, they cause serious harm to the body. Particular danger is observed if a woman has a birth injury, irritation or scratches in the vagina.

It is important to understand that toxic shock develops much faster than the flu. Therefore, a sharp increase in body temperature and vomiting should cause concern in a woman. Toxic shock requires emergency care.

Bacterial toxic shock

Bacterial toxic shock is sometimes also called septic shock. It can complicate the course of sepsis at any stage of its development. This phenomenon is an altered reaction of the body to the breakthrough of pyogenic microorganisms or their toxins into the blood.

This manifests itself in the form of high temperature, sometimes it reaches 40-41 degrees. At the same time, there is a stunning chill, which is characterized by strong sweating. It is possible that the temperature will drop to normal or subfebrile, due to strong sweating.

The mental state changes abruptly. The person feels anxiety, motor agitation, and in some cases psychosis. These symptoms manifest themselves simultaneously with a drop in blood pressure and oliguria, or even preceding them. The pulse is rapid and reaches 120-10 beats per minute. The skin becomes pale, acrocyanosis is noted, and breathing becomes more frequent. Urination is abruptly impaired. Toxic shock requires immediate elimination.

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Infectious toxic shock in pneumonia

Infectious toxic shock in pneumonia is a special disease. It is characterized by damage to the alveoli (thin-walled bubbles that saturate the blood with oxygen). The cause of this phenomenon can be a number of pathogens. These are mainly: intracellular parasites, fungi, bacteria and viruses.

Different types of pneumonia have their own characteristics. It can often develop against the background of previous illnesses, as a complication. Infectious toxic shock is a very severe complication. It most often occurs against the background of bilateral pneumonia.

Toxic shock also develops in severe pneumonia, which is characterized by serious infiltration of the lung tissue. The onset of a complication can be determined by early signs. Thus, inhibition or anxiety appears. Usually, these symptoms do not attract attention, which leads to a worsening of the situation. Over time, shortness of breath, tachycardia appear, and paleness of the extremities is also possible. The skin becomes dry and warm. Toxic shock requires immediate elimination.

Infectious toxic shock in children

Infectious toxic shock in children is a serious and dangerous condition. It can be caused by complex infectious diseases. The cause of this phenomenon lies in the entry of microorganisms and toxins released by them during their life processes into the blood.

Toxins actively develop in the body and lead to spasms of small vessels and capillaries. In children, this phenomenon mainly occurs against the background of scarlet fever, diphtheria, dysentery and meningococcal infection. Everything actively develops in the first day. At the same time, a sharp increase in temperature is observed, up to 41 degrees.

The child's condition remains extremely serious. He has a headache, vomiting, severe chills, convulsions and confusion. The pulse weakens, the heart begins to beat faster. The mucous membranes and skin become pale, and heavy sweating is possible.

Infectious toxic shock in a baby can develop due to infection through a scratch or cut. Children should be warned against this and wounds should be treated with a special antiseptic in a timely manner. If negative symptoms occur, you should immediately consult a doctor. Self-medication in this case is inappropriate! If toxic shock is not treated correctly, a fatal outcome in this case is not excluded.

Stages of infectious toxic shock

There are four types of infectious toxic shock stages. So, the first "variation" is called the early reversible shock phase. It is characterized by a shock index of up to 0.7-1.0, tachycardia, muscle pain, abdominal pain, headache and central nervous system disorders. A feeling of anxiety, restlessness and depression are possible.

The second stage is called the late reversible shock phase. At this stage, there is a critical drop in blood pressure (below 90 mm Hg), and the shock index reaches 1.0-1.4. The victim has a rapid pulse, lethargy and apathy. There is a violation of blood microcirculation. This can be determined visually by the moist and cold skin, as well as its bluish color.

The third stage is the phase of stable reversible shock. The victim's condition deteriorates sharply. The pressure gradually drops, and the heart rate increases significantly. The shock index reaches 1.5. The bluish color of the skin and mucous membranes increases. Signs of multiple organ failure appear.

The fourth stage is the most dangerous – the phase of irreversible shock. General hypothermia sets in, the patient’s skin is earthy in color with bluish spots around the joints. It is impossible to eliminate toxic shock in this case.

Diagnosis of toxic shock

There are several types of diagnostics of toxic shock. Everything can be determined by the patient himself. Thus, the patient has a very "sad" and "heavy" appearance. The person is conscious, but pale, cyanotic, adynamic and inhibited.

The difference between the central and peripheral body temperature is up to 4°C. Diuresis is less than 0.5 ml/kg/hour. The Algover shock index gradually increases. The presence of toxic shock in a person can be determined visually and with additional measurement of blood pressure and pulse.

At the first stage, the patient's condition is severe. He is agitated and motorly restless. The skin is pale, there is tachycardia, moderate shortness of breath and decreased diuresis. At the second stage, there is agitation, which over time is replaced by inhibition. In this case, the skin is pale, there is tachycardia, DIC syndrome, hypoxia, hypokalemia and hypotension. At the third stage, there is pronounced cyanosis, impaired consciousness, a drop in blood pressure, anuria and irreversible changes in the organs. Toxic shock is life-threatening and must be eliminated immediately.

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Treatment of toxic shock

Treatment of toxic shock includes a whole range of measures. The intensive therapy program for this disease consists of complete restoration of the body. First of all, the main tasks in the therapy of toxic shock are solved. Then the fight against the source of infection in the body begins.

Next, exogenous and endogenous intoxication is eliminated. After a while, hypovolemia and stabilization of macrohemodynamic indices are activated. Then, the mechanisms of autoaggression should be stopped and the bioenergy deficit eliminated.

It is important to improve microcirculation in a timely manner. In general, the main goals of therapeutic measures are to restore microcirculation and stop disseminated intravascular coagulation. This is done by simultaneously persistent infusion therapy and intravenous administration of pharmacological drugs.

As noted above, treatment occurs in several stages and depends on the person's condition. So, if shock occurs as a result of using tampons or contraceptives in a woman, they should be removed from the body immediately. Infected wounds are cleaned of bacteria by scraping with a scalpel or scissors. To do this, the doctor makes an injection so that the damaged area becomes numb and the woman does not feel pain. This intervention is a surgical treatment of the wound. As soon as the source of infection is removed, the patient will feel relief.

Hormones and antibiotics are actively used to destroy bacteria. Prednisolone and Dexamethasone are used as hormonal drugs.

Prednisolone is used to eliminate allergic reactions and the effects of toxic shock. It is used only with the permission of a doctor. It is used internally, in the form of injections and locally. Internally - during or immediately after meals 0.025-0.05 g per day (in 2-3 doses), then the dose is reduced to 0.005 g 4-6 times a day (or 2-3 times a day 0.01 g). In the form of injections - intramuscularly (the contents of the ampoule are dissolved in 5 ml of water for injection, heated to 35-37 ° C, 0.03-0.06 g of the drug) and intravenously (jet or drip 0.015-0.03 g). Locally - for anti-inflammatory and antiallergic action, 0.5% prednisolone ointment is used for skin diseases. The drug has some contraindications. It should not be used by elderly people and those who often have herpes. Side effects such as water retention, hyperglycemia, muscle weakness and amenorrhea are also possible.

Dexamethasone. The drug has anti-inflammatory, anti-allergic, anti-shock, immunosuppressant and antitoxic properties. The drug is taken orally in tablet form in an amount of no more than 10-15 mg per day at the initial stage of treatment, followed by a decrease in the daily dose to 2-4.5 mg during maintenance therapy. The daily dose of the drug is divided into 3 doses. Maintenance small doses should be taken once a day, preferably in the morning. In ampoules, the drug is intended for intravenous, intramuscular, perarticular and intra-articular administration. The recommended daily dose of Dexamethasone for such methods of administration is 4-20 mg. In ampoules, the drug is usually used 3-4 times a day for 3-4 days, followed by a transition to tablets. The drug is used only with the permission of a doctor. It can cause side effects in the form of nausea, vomiting, stomach pain. In more complex cases, intracranial pressure, a tendency to develop infectious eye diseases, and weight gain may occur. As for antibiotics, Vancomycin, Daptomycin, and Linezolid are most commonly used.

Vancomycin. The drug is administered exclusively intravenously at a rate of no more than 10 mg/min. The duration of the infusion should be at least 60 minutes. The daily dose for adults is 0.5 g or 7.5 mg/kg every 6 hours or 1 g or 15 mg/kg every 12 hours. If a person has impaired renal excretory function, the dosage regimen is adjusted. In no case should the drug be used during pregnancy, breastfeeding, or by people who are hypersensitive to some components of the drug. Side effects such as nausea, vomiting, and allergic reactions are possible. In more severe cases, reversible neutropenia, anaphylactoid reactions, and hyperemia are formed.

Daptomycin. The drug is administered intravenously for at least 30 minutes. In complicated skin and soft tissue functions, 4 mg / kg once a day for 1-2 weeks is sufficient until the infection completely disappears. In bacteremia caused by Staph. aureus, including established or suspected infective endocarditis, the recommended dose for adults is 6 mg / kg 1 time / day for 2-6 weeks at the discretion of the attending physician. The drug may cause side effects. This manifests itself in the form of a fungal infection, mental disorders, nausea, vomiting and stomach pain. Hypersensitivity, swelling and chills are possible.

Linezolid. Adults are prescribed the drug intravenously or orally 2 times a day at 400 mg or 600 mg once. The duration of treatment depends on the pathogen, localization and severity of the infection: for community-acquired pneumonia 600 mg - 10-14 days, hospital pneumonia 600 mg - 10-14 days, skin and soft tissue infections 400-600 mg depending on the severity of the disease - 14-28 days, enterococcal infections - 14-28 days. Incorrect use of the drug can cause side effects. They manifest themselves in the form of nausea, vomiting, stomach pain, headache and reversible anemia.

It should be noted that each case is somewhat individual. Therefore, it is necessary to eliminate toxic shock only after a doctor's examination and identification of the stage of the "disease".

Emergency care for infectious toxic shock

Emergency care for infectious toxic shock should begin before the person is hospitalized. Before the doctor arrives, try to warm the person up and put a heating pad on their feet. Then remove or unbutton any tight clothing. This will provide access to fresh air.

Immediately after hospitalization, the person is transferred to the intensive care unit. Here, appropriate therapy is performed. Before antibiotics are prescribed, blood cultures are performed. If possible, all of this is extracted from the foci of infection.

The complexity and severity of the septic process require treatment aimed not only at combating microorganisms, but also at eliminating metabolic disorders caused by intoxication and hypoxia. After vital functions are restored, the foci of infection are sanitized. For emergency care, the following are used: intravenous drip administration of 200 mg of Dopamine, prednisolone at a dose of 10-15 mg / kg / day and oxygen inhalation. Further treatment depends on the condition. In any case, toxic shock must be eliminated immediately.

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Prevention of toxic shock

Prevention of toxic shock consists of following certain rules. Thus, women are advised not to use tampons and barrier contraceptives. The latest "inventions" are sponges, diaphragms and caps. You should not use all of this for 3 months after giving birth. Because the vagina needs a lot of time to recover. Then you can use tampons, but change them every 8 hours. You should not leave a contraceptive diaphragm or sponge in for more than twelve hours.

The skin should always be clean. Abrasions and wounds should be treated immediately to prevent infection, which can cause toxic shock.

If a woman has experienced menstrual toxic shock syndrome, she should stop using intrauterine devices, tampons, and barrier contraceptives. Toxic shock is a serious disorder that can lead to dysfunction of organs and body systems.

Toxic Shock Prognosis

The prognosis for toxic shock is relatively favorable. Successful recovery in people who have suffered this complication depends on the timeliness of diagnosis and treatment.

It is important that emergency care is provided quickly and professionally. Antibacterial therapy must be adequate and successful. The main thing is that the sanitization of the main bacterial focus is carried out correctly and effectively.

Despite this, the mortality rate is high, but only in the first hours. If infectious toxic shock was caused by streptococcus, the mortality rate reaches 65%. The causes of death are heart failure, multiple organ failure and arterial hypotension. With timely and adequate assistance, the patient fully recovers in 2-3 weeks. It is important to understand that prevention is much easier than cure. Toxic shock is a serious deviation that negatively affects many systems and organs of the human body.

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