title: [Tampon disease, still not past tense].
abstract: On the basis of three case histories we discuss the menstrual toxic shock syndrome (TSS), characterised by multi-organ involvement, fever, exanthema and shock. The symptoms are provoked by a toxin (TSST-1), a product of certain St. aureus strains. Rapid recognition is important in order to prevent complications such as the adult respiratory distress syndrome, disseminated intravascular coagulation or ventricular fibrillation. It appears that a tampon can lower the magnesium concentration in the vagina by a process of ion exchange, thus creating an environment that favours the production of TSST-1 by St. aureus. This knowledge may lead to preventive measures in the production of tampons in the future.
authors.affiliation: Ziekenhuis Gooi-Noord, afd. Inwendige Geneeskunde, Blaricum.
authors.forename: P C
authors.initials: PC
authors.lastname: van de Meeberg
authors.forename: H P
authors.initials: HP
authors.lastname: Muller
authors.forename: F C
authors.initials: FC
authors.lastname: Henny
mesh_terms: D000293:Adolescent; D000328:Adult; D003422:Critical Care; D005260:Female; D006801:Humans; D052576:Menstrual Hygiene Products / Q000009:adverse effects; D008598:Menstruation; D010493:Pericarditis / Q000209:etiology; D011654:Pulmonary Edema / Q000209:etiology; D012772:Shock, Septic / Q000150:complications* / Q000175:diagnosis / Q000628:therapy
vernacular_title: Tamponziekte, nog geen verleden tijd.