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Toxic Shock Syndrome

  • Cynthia M. Johnson, MA
Publication Type:


Toxic Shock Syndrome



Toxic shock syndrome (TSS) is a rare, severe illness that affects the whole body. It can worsen quickly and become deadly if it is not treated right away.

There are two types:

  • Menstrual type—linked to tampon use in women
  • Non-menstrual type—linked to surgery, wounds, burns, and other skin injuries that can happen to people of any age


TSS happens due to an infection with specific types of bacteria that make toxins that damage systems in the body.

TSS has been linked to using a specific type of highly absorbent tampon. These tampons are no longer sold and TSS from tampon use has decreased.

Immune System.

The immune system creates antibodies to fight bacteria.

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Risk Factors

Things that may raise the risk of TSS are:

  • Tampon use
  • Using birth control devices that are placed in the vagina
  • Skin sores, such as burns
  • Surgical wounds, especially those packed with gauze to control bleeding
  • Recent childbirth
  • Sinusitis
  • Respiratory infections following influenza


TSS symptoms start suddenly and worsen quickly. Problems may be:

  • Fever
  • Headache
  • Lightheadedness and fainting
  • Nausea and vomiting
  • Diarrhea
  • Body aches
  • Weakness
  • Tiredness
  • A sunburn-like rash
  • Peeling of the skin on the hands and feet
  • Confusion

Without proper treatment, TSS can lead to organ failure or death.


The doctor will ask about symptoms and health history. A physical exam will be done. Women may also have a pelvic exam.

Tests will be done to look for signs of infection. This can be done with:

  • Blood tests
  • Urine tests
  • Tissue samples from the vagina, throat, or wound


Emergency care will be needed to stop TSS from getting worse. It may include IV fluids, breathing support, and kidney care.

Antibiotics will be given to treat the infection. Other medicines may also be given to:

  • Ease pain
  • Lower fever
  • Control blood pressure
  • Support the immune system

The menstrual type of TSS will be treated by removing tampons or birth control devices from the vagina.

The non-menstrual type will be treated by cleaning and draining infected wounds. Any dead tissue will also need to be removed.


The risk of menstrual type TSS may be lowered by:

  • Alternating between tampons and sanitary pads
  • Not using tampons at night
  • Changing tampons every 4 to 8 hours
  • Using a tampon with the lowest absorbency for the menstrual flow a person has
  • Using tampons only when menstruating
  • Using vaginal contraceptives as directed

TSS in others may be lowered by keeping wounds clean and seeking care at the first sign of infection.





  • Staphylococcal toxic shock syndrome. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/staphylococcal-toxic-shock-syndrome.
  • Toxic shock syndrome. Kids Health—Nemours Foundation website. Available at: http://kidshealth.org/en/parents/toxic-shock.html.


  • David L. Horn, MD, FACP
Last Updated:

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.