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  • Title: Toxic shock syndrome associated with diaphragm use.
    Author: Given WD.
    Journal: W V Med J; 1986 Jun; 82(6):171-3. PubMed ID: 3460269.
    Abstract:
    This article presents a case of toxic shock syndrome associated with the use of a diaphragm. The patient, a 31-year-old white female, presented with symptoms of shock and bilateral lower quadrant pain. A diagnosis of toxic shock syndrome was made on the basis of the patient's fever, rash, desquamation, and involvement of the gastrointestinal, muscular, mucous membrane, renal, and hematologic organ systems. The patient had discontinued oral contraceptive use 3 weeks earlier and had used a diaphragm for birth control the day before the onset of illness. The device was in place for 10 hours. She was not a tampon user. The diaphragm is considered to be the most likely etiologic agent in this case of toxic shock syndrome, although a specific pathophysiologic mechanism has not been identified. Caution should be exerted in prescribing the diaphragm to patients with a prior history of this syndrome.
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