Septic shock is a medical emergency that can lead to amputation if left untreated. Among its causes in women, the improper use of sanitary tampons. Hypotension and fever are warning signs.
Septic shock is caused by a rare infection but serious most commonly caused by bacteria called “Staphylococcus aureus”. The use of tampons or sanitary napkins prolonged is one of the recognized causes of septic shock in women. Patients who survive septic shock are at risk of serious sequelae, including amputation for the most serious cases. What can cause septic shock? What are the signs? And the treatments?
What is septic shock?
Septic shock is a acute circulatory failure manifesting itself by a sudden drop in blood pressure, caused by a bacterial infection most frequently, but sometimes viral or fungal (yeasts). This is the clinically most severe form of the infection in humans. “Septic shock is caused by the presence of infectious microorganisms in the blood (sepsis) or in fabrics usually sterile (lung, urine, etc.), specifies Dr Nicolas Devos, resuscitator anesthesiologist. The vital prognosis can be quickly committed hence the therapeutic urgency.”
Causes: what can cause septic shock?
The pathophysiology of septic shock is complex. “In response to an infection, the body triggers an important inflammatory defense reaction even “excessive” whose immediate consequences are acute circulatory failure”, details our doctor. The initial infection will cause a low blood pressure (by vasodilation and increase in the permeability of the vessels). Thus, the organs will be unevenly supplied with blood. This translates into the dysfunction of certain organs and the appearance of circulatory disturbances characteristic of septic shock. Toxic Shock Syndrome (TSS) is a rare but serious infectious disease, most commonly caused by bacteria called “Staphylococcus aureus“. In the majority of cases, this bacterium is not dangerous. But in certain predisposed people, with weak immunity, the bacterium can multiply, then causing an infection and producing toxins. The main cause of menstrual toxic shock syndrome is the use of vaginal tampons or menstrual diapers for too long a period (more than 4 to 6 hours). Indeed, during menstruation, the pH of the vagina changes. It becomes alkaline (less acidic). However, this medium represents a favorable culture medium for Staphylococcus aureus. So, if the blood stays too long in the vagina, the bacteria can grow and cause the infection.
What are the symptoms of septic shock?
Septic shock causes low blood pressure, occurring suddenly in a person with temperature above 38.5, but also sometimes in hypothermic patients with a temperature below 35 degrees. Also occur a paleness, chills, tachycardia, increased breathing rate, decreased amount of urine emitted, coldness and cyanosis of the extremities, disturbances of consciousness or even a coma. Other signs are in favor of the septic origin of the shock such as chills, fever or, on the contrary, hypothermia or an infection which has been identified or suspected.
“The diagnosis of septic shock is made in associating a clinical picture of infection and severe arterial hypotension witnessing acute circulatory failure” adds our interlocutor. Blood samples are taken and the blood is cultured (blood cultures) to identify the bacterium in question.
What are the treatments for septic shock?
A patient with septic shock should be treated urgently in an intensive care unit. Treatment depends on the nature, cause and intensity of the septic shock. First, the doctor dispenses infusions to increase the volume circulating in the blood vessels. “If this filling is insufficient, we can resort to other emergency medicine norepinephrine or adrenaline, says Dr. Devos. In case of respiratory failure associated, the patient may be placed on artificial ventilatory assistance. At the same time, the patient is urgently administered antibioticstreatment which will be subsequently adapted according to the germ identified on the blood cultures.
What are the consequences of septic shock?
The faster the infection is treated, the more likely the patient is to survive. If it is treated late, the consequences can be serious. For example, it can degenerate into gangrene and lead to a amputation.
What are the neurological sequelae after septic shock?
Despite advances in research, patients who have survived septic shock are victims of mainly cognitive and neuropsychological sequelae. The place of the psychologist and the work in interdisciplinarity are therefore preponderant to best support patients and their families.
“Any severe infectious picture with severe general manifestations (fever >40° with chills, arterial hypotension) is a therapeutic emergency and must be treated in a specialized environment” insists our specialist. An effective diagnosis and management improve the prognosis more than significantly. Bacterial infection must be treated urgently in a hospital setting in order to start antibiotic treatment as soon as possible. On the other hand, it is necessary extra vigilance in the operating room with strict asepsis and respect for basic hygiene rules.
Thanks to Dr Nicolas Devos, Anesthesiologist at the Clinique de l’Europe in Rouen (Vivalto Health Group).