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Suggest Treatment For Symptoms Of Residual From Toxic Shock Syndrome

Posted on Tue, 3 Feb 2015

Question: My now 16 yo daughter had toxic shock syndrome at age 15 they say from tampon use and was hospitlized for 4 days. She has never been the same. She drives now and is a great student. Very athletic and competive. 120 lbs and 5.5. Since then she gets very pale quite often. She feels faint and claminess. Sometimes vomiting. Frequent low bp. Testing ruled out thyroid, cardiac and anemia. Worse episode 3 days ago while at store. Comes on suddenly and we are fearful of her driving or fall injury. Your thoughts please? Thank you!

Answered by Dr. Sumanth Amperayani (52 minutes later)

Brief Answer:
Need more information please

Detailed Answer:
Hi...please answer questions below -

1. Any personal or family history of seizures?
2. Does she back out completely?
3. Dose she fall if it occurs while standing?
4. Has an EEG or MRI brain have been done?
5. Is there family history of psychological illnesses?

I will guide you more scientifically after you get back with answers.

Regards - Dr. Sumanth

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sumanth Amperayani (7 hours later)

No family history of seizures or psychoogical illnesses. She claims she has not copletely blacked out. They seem to occur moreso while standing but feels faint even while sitting and says that her classmtes often tell her she is very pale. t even happens while competing in volleyball or softball (sometimes vomiting is involved). I notice it quite often and can sometimes last a day or 2 at a time. An eeg, heart ultrasound, ekg, halter monitor, numerous blood test and doctor vsits. There was metion of mvp by the cardiologist but he sais it is quite common and typically does not present a problem. Im convinced that this is a residual from the toxic shock syndrome. This was never present previously. Just very concerned and need answers. Our family practice doctor said they may want to do a tilt test and would call the cardiologist to discuss. Thanks so much! XXXX

Answered by Dr. Sumanth Amperayani (4 hours later)

Brief Answer:
Vertigo/ Absence Seizures /Malingering

Detailed Answer:
Hi....I have gone through the details you have provided. I understand your concerns.

The possibilities I am putting forth come in this order of consideration -

1. Vertigo - everything fits in except the palor.
All the tests you have mentioned can be normal, and she can be symptomatic with vertigo. Your pediatrician was right, MVP cannot be the reason for all the symptoms.

2. Absence seizures - whatever you have described fits into this diagnosis, but EEG cannot be normal. But nevertheless it is still a possibility.

3. Malingering - This is a diagnosis of exclusion and should be considered only after excluding all other clinical possibilities. I am considering this keeping in mind her gender and age, but I again reiterate that it is a diagnosis of exclusion. It's the least of possibilities.

Regards - Dr. Sumanth

Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Raju A.T