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Síndrome de shock tóxico
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Síndrome de shock tóxico

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Es una enfermedad grave que implica fiebre, shock y problemas con el funcionamiento de algunos órganos corporales.

Causas, incidencia y factores de riesgo
El síndrome de shock tóxico es causado por una toxina producida por ciertos tipos de las bacterias estafilococos. Un síndrome similar, llamado síndrome tóxico similar al shock (TSLS, por sus siglas en inglés), puede ser causado por las bacterias estreptococos.

Aunque los primeros casos del síndrome de shock tóxico descritos comprometían principalmente a mujeres que estaban utilizando tampones durante sus períodos (menstruación), hoy en día menos de la mitad de los casos actuales están asociados con ese hábito. Este síndrome también puede ocurrir con infecciones cutáneas, quemaduras y después de cirugía. La enfermedad también puede afectar a niños, mujeres posmenopáusicas y hombres.

Los factores de riesgo abarcan:

Parto
Infección por Staphylococcus aureus (S. aureus), comúnmente llamada infección estafilocócica
Cuerpos extraños o tapones (como los que se utilizan para detener el sangrado nasal)
Menstruación
Cirugía
Uso de tampón vaginal, particularmente si se deja por mucho tiempo
Uso de anticonceptivos de barrera, como un diafragma o la esponja vaginal
Infección de una herida después de cirugía
Síntomas
Confusión
Diarrea
Malestar profundo (indisposición)
Dolores de cabeza
Fiebre alta y acompañada en algunas ocasiones por escalofríos
Hipotensión
Dolores musculares
Náuseas y vómitos
Insuficiencia en órganos (generalmente los riñones y el hígado)
Enrojecimiento de ojos, boca y garganta
Crisis epilépticas o convulsiones
Erupción roja y generalizada que se asemeja a una quemadura solar: la descamación de la piel ocurre una o dos semanas después de la erupción, especialmente en las palmas de las manos o plantas de los pies
Signos y exámenes
No existe un examen particular de diagnóstico para el síndrome de shock tóxico.

El diagnóstico se basa en varios criterios: fiebre, presión arterial baja, erupción descamativa después de 1 a 2 semanas y problemas con el funcionamiento de al menos tres órganos.

En algunos casos, los hemocultivos pueden ser positivos para la proliferación de S. aureus.

Tratamiento
Se extraerá cualquier material extraño, como tampones, esponjas vaginales o tapones nasales. Asimismo, se drenarán los sitios de infección (como heridas quirúrgicas).

El objetivo del tratamiento es mantener las funciones corporales importantes, lo cual puede comprender:

Antibióticos para cualquier infección (se pueden administrar por vía intravenosa)
Diálisis (si se presentan problemas renales graves)
Líquidos intravenosos
Métodos para controlar la presión arterial
La gammaglobulina intravenosa puede ayudar en casos graves
Expectativas (pronóstico)
El síndrome del shock tóxico puede ser mortal hasta en el 50% de los casos y puede reaparecer en aquellas personas que sobreviven.

Complicaciones
Disfunción orgánica severa
insuficiencia renal
insuficiencia cardíaca
insuficiencia hepática
Shock
Situaciones que requieren asistencia médica
El síndrome del shock tóxico es una emergencia médica. Busque atención médica inmediata si presenta una erupción, fiebre y se siente enferma, en particular durante la menstruación y el uso de tampones, o si usted ha tenido una cirugía reciente.

Prevención
El síndrome del shock tóxico menstrual se puede prevenir evitando el uso de tampones altamente absorbentes. Usted puede disminuir el riesgo cambiando los tampones con más frecuencia y utilizando tampones sólo de vez en cuando (no regularmente) durante la menstruación. Medline Plus

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