Prodromes of Menstrual Staphylococcal Toxic Shock

Inclusion Criteria :

+Case inclusion criteria:

• Women between 13 and 30 years old inclusive

• Clinical diagnosis of staphylococcal toxic shock syndrome: "confirmed" or "probable"according to Center Disease Control (CDC) criteria:

The 5 CDC clinical criteria for menstrual Staphylococcal Toxic Shock are:

• a fever above 39°C,

• arterial hypotension,

• generalized scarlatiniform erythroderma

• intense peeling of the palms or soles of the feet 7 to 14 days later,

• and systemic manifestations (at least three):

• Digestive: vomiting, diarrhea

• Muscular: myalgia, increase in serum creatine phosphokinase

• Hyperemia of the vaginal, oropharyngeal and conjunctival mucous membranes

• Renal: hyperuricemia, hypercreatininemia, leukocyturia without urinaryinfection,

• Hepatic: increase in transaminases

• Hematological: thrombocytopenia (< 100,000 platelets/mm3)

• Neurological: apart from episodes of fever or hypotension such asdisorientation or altered consciousness.

In the presence of 4 criteria, the case is considered probable and 5 criteria as confirmed case.

• Detection of S. aureus strain carrying Toxic shock syndrome toxin-1 (TSST1) onvaginal samples.

• Onset of symptoms ≤ 72 hours before the start of menstruation and ≥ 72 hours afterthe end of menstruation.

• Use during the last 3 cycles of vaginal protection: tampon or menstrual cup.

+Control inclusion criteria:

• Women between 13 and 30 years old inclusive

• Presence of menstruation

• Use of intimate periodic protection, tampon or menstrual cup, during the last 3periods

• No history of toxic menstrual shock

Exclusion Criteria:

• Non-menstruating women

• Women protected by law

• Women (or relatives) who oppose the study