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Possible Role of the Pessary in the Etiology of Toxic Shock Syndrome
Author(s) -
Leidy Lynnette E.
Publication year - 1994
Publication title -
medical anthropology quarterly
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.855
H-Index - 55
eISSN - 1548-1387
pISSN - 0745-5194
DOI - 10.1525/maq.1994.8.2.02a00040
Subject(s) - pessary , toxic shock syndrome , medicine , shock (circulatory) , etiology , vagina , uterus , pelvic inflammatory disease , gynecology , surgery , staphylococcus aureus , biology , bacteria , genetics
Medical technology often has unforeseen effects on human health. For example, indwelling urethral catheters promote gram‐negative endotoxin shock, and improved absorbency in tampons triggered an epidemic of toxic shock syndrome. The pessary is an ancient gynecologic device used to support or position a displaced or prolapsed uterus. As an invasive device, similar to a vaginal tampon or contraceptive diaphragm, the pessary may have increased a woman's risk of vaginal infections, possibly including toxic shock syndrome, especially during the 19th century when prolapsus uteri was a common diagnosis among young women. Evidence for the involvement of the pessary in the syndrome is drawn from early medical texts that attribute toxic‐shock‐type symptoms, specifically high or fatal fevers, to absorbent pessaries. Further evidence comes from the culture of Staphylococcus aureus from nonabsorbent pessaries.