Tri-state toxic shock syndrome study: Evaluation of case definition and prevention of recurrence

The clinical and laboratory findings in 80 nonfatal cases of toxic shock syndrome were examined as part of the Tri-State Toxic-Shock Syndrome Study conducted by the state health departments of Minnesota, Wisconsin, and Iowa. Symptom criteria included in the case definition were analyzed and certain criteria identified that may be helpful in screening febrile patients early in an episode of toxic shock syndrome or those with mild cases. We also report a 5-month follow-up of the 80 patients and have found that use of antistaphylococcal antibiotics during the initial episode and discontinued tampon use after the initial episode are significant and statistically independent factors in decreasing the rate of recurrent toxic shock syndrome.