Toxic Shock Syndrome
Condition
(TSS)
Definition
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
Causes
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.
The immune system creates antibodies to fight bacteria.
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Risk Factors
Things that may raise the risk of TSS are:
Symptoms
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.
Diagnosis
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
Treatment
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.
Prevention
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.
The American Congress of Obstetricians and Gynecologists
Centers for Disease Control and Prevention
CANADIAN RESOURCES:
The Society of Obstetricians and Gynaecologists of Canada
Women's Health Matters—Women's College Hospital
The American Congress of Obstetricians and Gynecologists
Centers for Disease Control and Prevention
CANADIAN RESOURCES:
The Society of Obstetricians and Gynaecologists of Canada
Women's Health Matters—Women's College Hospital
References
- 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.
Contributors
- David L. Horn, MD, FACP
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