ABSTRACT

It is interesting that TSS caused by Staphylococcus aureus, which gynecologists equate with menstruation and tampon use, was first definitely described and named by James Todd, a pediatric infectious disease expert. His report, published in 1978, is a description of seven children and adolescents of both sexes, none of whose cases was associated with either menstruation or the use of vaginal tampons1. Following this description of a new clinical entity, there was a plethora of cases culminating in a peak incidence of TSS cases reported in 19802. Nearly every one of these

cases occurred in menstruating women using tampons. All physicians in the United States, and the Centers for Disease Control (CDC) in particular, focused upon this entity, and over a period of years, there has been a diminution in the number of reported cases3 (114). There were many factors contributing to this decline. The super-absorbent tampon which could remain in place for long periods of time was withdrawn from the market, even though TSS has been reported with all tampons, and physicians, more aware of this syndrome, diagnosed this entity in the early stages of the disease and initiated antibiotic treatment before multiorgan involvement was encountered. TSS is still seen today, but for most gynecologists, it is a rarely encountered clinical entity.