Dr. Balentine received his undergraduate degree from McDaniel College in Westminster, Maryland. He attended medical school at the Philadelphia College of Osteopathic Medicine graduating in1983. He completed his internship at St. Joseph's Hospital in Philadelphia and his Emergency Medicine residency at Lincoln Medical and Mental Health Center in the Bronx, where he served as chief resident.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Toxic shock syndrome is a serious, life-threatening illness caused by
toxins released by two specific types of bacteria,
group A Streptococcus and
Staphylococcus aureus.
Although most commonly associated with tampon use in
menstruating females, it can also occur in the setting of postsurgical wound
infections as well as skin and other infections.
There is no one specific test
that establishes the diagnosis of TSS.
TSS requires emergency care, including
intravenous fluid and antibiotics.
Toxic shock syndrome is a dangerous condition of life-threatening progressive
lowering of blood pressure,
dizziness, confusion, peeling of the skin of the palms and soles of the feet (which develops after one to two weeks of
rash),
headaches, and occasionally
seizures and death caused by bacterial toxins.
What causes toxic shock syndrome?
Toxic shock syndrome (TSS) is a life-threatening condition caused by toxins
produced by certain types of bacteria. This condition has been most
often associated with the use of tampons in menstruating women. In 1980, an
outbreak of TSS was linked to the use of one brand of superabsorbent tampons.
Although this outbreak was linked to toxins produced by the Staphylococcus
aureus bacteria, TSS can also be caused by toxins from the group A Streptococcus
bacteria. The condition is sometimes subdivided and referred to as staphylococcal TSS and streptococcal TSS.
Although this disease has been frequently linked to the use of tampons in
women, it can affect people of any gender and any age. About half
of the reported cases have been linked to the use of tampons in menstruating
women, while the remaining cases are due to other situations. Tampons,
especially when left in place for a long period of time, are thought to provide
a breeding ground for the bacteria that subsequently release toxins to cause TSS.
When not linked to tampon use, TSS can occur as a complication of surgery or
skin infections.
Reviewed by William C. Shiel Jr., MD, FACP, FACR on 8/24/2012
Toxic shock syndrome requires immediate emergency care in a hospital setting. If you suspect you are suffering an attack, get medical help as soon as possible. If your doctor is not available, call 911 or get to a hospital emergency room right away. Have someone take you, because you may quickly become too shaky to drive yourself.
Treatment for this life-threatening condition must be aggressive. Your doctor or emergency room personnel will start by giving you antibiotics to kill the bacteria and limit further release of toxins. Other urgent steps -- necessary to control your body's response to the toxins and to support vital functions -- may include blood transfusion and intravenous fluids and electrolytes to stabilize your blood pressure. Some cases call for a ventilator, which will temporarily breathe for you. Caregivers will monitor vital signs constantly during the acute phase of this disease.
Low blood pressure, also referred to as hypotension, is blood pressure that is so low that it causes symptoms or signs due to the low flow of blood through
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