According to the British Medical Journal most cases of toxic shock syndrome in the UK have been attributed to tampon use. The condition is rare in children. However if misdiagnosed or left untreated, liver and kidney damage can result with fatal results.
The syndrome is caused by the bacteria staphylococcus aureus, a bacteria that is normally found living harmlessly on the skin. The toxin released by the bacteria on entering the blood stream sets off the syndrome.
As to what triggers the bacteria to produce the toxin is yet unknown. Initial symptoms are often flu-like or may instead involve a rash and diarrhea.
The Birmingham doctors cite two cases of children having developed toxic shock syndrome following blisters developed due to football boots.
The first case involves a 13-year-old girl who developed friction blisters over the heels of both legs after playing a competitive game of football in new boots.
After developing symptoms such as fever, abnormally low blood pressure, rash, vomiting and diarrhea, she was admitted to a local hospital. On further examination blisters about 2cm in diameter were seen over each of her Achilles tendons. Diagnostic tests revealed the presence of the bacterium Staphylococcus aureus carrying the toxic shock syndrome gene, in the blister. She recovered following treatment with antibiotics.
The second case involved an 11-year-old boy who developed a blister on his right heel following a competitive game of football in a new pair of boots. He developed fever, rash vomiting and diarrhea over the next two days and admitted into a hospital. His condition deteriorated. Hypotension was noted. Laboratory tests of the pus from the blister revealed the presence of Staphylococcus aureus.
Mark Taylor, a consultant at Birmingham's Children's Hospital and author of the report said: 'These cases show that the syndrome may follow relatively trivial skin trauma.
'We suggest that doctors consider toxic shock syndrome in a child with rash, fever and hypotension. They need to search carefully for the primary infection, as it may not be immediately obvious, and to be aware that secondary rashes occur.'