Children can get Toxic Shock Syndrome too – do you know the symptoms?

Time to call the doctor …

Written by TSSIS, 2002

If your child showed flu like symptoms coupled with vomiting and diarrhoea would you be unduly worried? Most parents would simply resolve to stay at home with their son or daughter and tend to their needs until the condition subsides, with perhaps a trip to the local G.P. or a call to NHS Direct if things did not improve.

However on rare occasions these symptoms, when associated localised infections such as burns, scalds, boils or insect bites (particularly if accompanied by a high fever, drowsiness and sunburn-like rash) can be early signs of a very serious illness indeed: toxic shock syndrome (TSS).

TSS can affect anyone or any age. Most women will be aware of the form of TSS associated with menstruation and tampon use, but may not realize it can occur in any member of the family. At present, as cases of menstrual TSS are becoming less common, the incidence of TSS in children looks as if it may be increasing, particularly following burns. The risk of TSS is greater in younger people as they are less likely to have developed sufficient protective antibodies to the toxin which causes the illness.

Christopher Withey In July 1999, seven year old Christopher Withey was accidentally splashed with hot water while melting chocolate with his mother, brothers and sister. He was taken to the local community hospital where the minor scald on his back – less than a one per cent burn - was treated. A few days later Christopher became very unwell with a high fever, sickness and diarrhoea. Mrs Withey returned with Christopher to the hospital ten times in ten days, partly to have the scald checked but also because she was increasingly concerned about his health. On all but the last visit, she was assured Christopher simply had a ‘stomach bug’. Finally, doctors recognised Christopher was indeed severely unwell, and he was rushed to a children’s hospital. Tragically, Christopher died soon after. He was diagnosed as suffering from Toxic Shock Syndrome which had occurred as a result of the burn.

Consultant paediatrician Dr Colin Michie, of Ealing NHS Trust is familiar with TSS in children. He explains ‘Burns and scalds often damage normal skin defences, allowing bacteria to grow and make potentially dangerous toxins. For many years it has been known that children with burns may develop confusion, fever, low blood pressure, diarrhoea and a rash – in other words, toxic shock syndrome. This condition may be seen following very small areas of skin damage and tragically, can be fatal. Of the various cases I have seen – and it is rare - the diagnosis has been made quite late, when the child was already very unwell. This can be avoided. Such children were thought to have gastroenteritis, or a viral infection of some type. A useful message would be for any sick child with a burn or scald to have a blood pressure check, in order to exclude shock.”

So while TSS is a rare illness indeed, it is important to be aware of its potential causes and symptoms. If caught early, it can be successfully treated with antibiotics and fluids. This results in an excellent outcome with no long-term complications. The onset of TSS is like a very severe ‘flu with symptoms including some or all of the following:

    • Sudden high fever
    • Vomiting
    • Diarrhoea
    • Fainting or feeling faint
    • Muscle aches
    • Dizziness
    • Confusion
    • Sunburn-like rash

Medical attention should be sought early for anyone who may be at risk, either by calling the local G.P. or visiting the nearest Accident and Emergency department. An accurate blood-pressure measurement must be performed in order exclude shock, or low blood pressure.