Toxic shock syndrome--an adolescent disease.

Over the past 3 years, toxic shock syndrome (TSS) has emerged from virtual obscurity to become a household word. The syndrome, which most commonly occurs in previously healthy women during menses, is characterized by the sudden onset of headache, malaise, high fever, myalgia, diarrhea, syncope, skin rash, and evidence of multisystem involvement with progression to desquamation of skin, nails, and hair. Death has occurred in 5%-10% of cases. Use of highly absorbent tampons and the presence of toxin-producing staphylococcus aureus have been implicated in the pathogenesis of this syndrome. Treatment with beta-lactamase-resistant antibiotics and discontinuation of tampon use are associated with reduction in the risk of recurrence. To date, 42% of cases have occurred in females under the age of 19 years. Accordingly, physicians who care for adolescents should be knowledgeable about the syndrome's myriad manifestations and treatment, as well as the possibility of prevention through education about menstrual practices.