Toxic Shock Syndrome Following Submucous Resection and Rhinoplasty

IN 1978, the illness known as toxic shock syndrome (TSS) was first described by Todd and co-workers.1During 1979 and 1980 the number of patients recognized as having this disease increased dramatically, and recent publications have described in detail the epidemiology and nature of the illness.2,3Although there is a striking association between vaginal colonization withStaphylococcus aureus, menstrual bleeding, and the use of vaginal tampons, the pathogenesis of TSS is not completely understood. The presence of an occlusive tampon together with breaks or abrasions of the vaginal mucosa may allow multiplication ofS aureusand perhaps enhance the absorption of a toxin elaborated by this organism.3 The combination of menstruation and tampon use is thought to contribute to production of the disease in the great majority of instances. Recently, Reingold and associates4described a number of patients with TSS that was not associated with menses