Toxic Shock Blamed in Girl’s Death : 15-Year-Old Had No Blood Pressure When First Examined

An autopsy has found that a 15-year-old San Diego girl, Terri Wetterling, died of toxic shock syndrome early Monday after she was taken by ambulance to Children’s Hospital, the hospital’s medical director said Tuesday night.

“The mechanism that resulted in her death appears to be the presence of a tampon which allowed the development of a vaginal infection,� said Dr. David Chadwick.

Chadwick said the girl’s parents indicated that she had been “feeling badly for a day or so� when they took her to an out-patient clinic Sunday. Her condition had deteriorated to the point that doctors at the clinic reported that she had no blood pressure, Chadwick said.

Wetterling was rushed to Sharp Memorial Hospital and later transferred to Children’s, presumably because of her age, Chadwick said. She died about 4 a.m. Monday.

Children’s spokesman Vince Bond said the hospital treated a young woman suffering from toxic shock syndrome about six months ago. She recovered.

“Toxic shock is a rarity now,� Chadwick noted. “It’s also a fact that most of the cases don’t die. There is a mortality rate of about 10 to 20%. We had two or three cases when there were many of these throughout the nation, but this certainly doesn’t suggest that it’s become epidemic.�

The number of recent cases of toxic shock syndrome in San Diego County could not immediately be determined.

San Diego County Health Department Director Dr. Donald Ramras could not be reached for comment. However, a San Diego newspaper quoted him Tuesday as saying that there were nine reported cases of toxic shock in the county last year, none of them fatal.

In 1979, a 12-year-old Mira Mesa girl, Pamela Helena Schutzius, died of the disease.

First reported in 1975, toxic shock syndrome has resulted in more than 100 deaths nationwide, according to the U.S. Public Health Service.

Many of the cases initially occurred in women using Rely tampons, but cases involving other tampon brands subsequently turned up.

Symptoms of toxic shock syndrome, which hits its victims suddenly, include high fever, aching muscles, skin rash, vomiting and diarrhea. Scaling of the skin, especially on the soles of the feet and the palms of the hands, follows. Death can occur when loss of fluids causes a sharp drop in blood pressure, followed by shock.