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Possible Role of the Pessary in the Etiology of Toxic Shock Syndrome

Lynnette E. Leidy
Medical Anthropology Quarterly
New Series, Vol. 8, No. 2 (Jun., 1994), pp. 198-208
Published by: Wiley on behalf of the American Anthropological Association
Stable URL: http://www.jstor.org/stable/648695
Page Count: 11
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Possible Role of the Pessary in the Etiology of Toxic Shock Syndrome
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Abstract

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.

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