Toxic Shock Syndrome
by Debra Wood, RN
Toxic shock syndrome (TSS) is a group of symptoms throughout the body. This illness can progress rapidly. It can lead to a failure of multiple body systems. Toxic shock syndrome can be fatal.
There are two types of TSS:
TSS is caused by toxins released from specific bacteria.
Bacteria infects the body through cuts or sores. The bacteria can create toxins as it grows. These toxins are harmful to many of your body's systems. The damage to your body is what causes the range of symptoms.
TSS was originally associated with tampon use. It was common in women who used a particular type of highly absorbent tampons. As a result, these tampons were removed from the market. The number of TSS infections due to tampons has since significantly decreased.
Risk Factors TOP
Factors that increase your risk of TSS include:
A person with TSS often appears very ill. Symptoms usually come on suddenly. Fever, chills, and body aches may start up to 4 days before other symptoms develop such as:
Symptoms of severe TSS include:
The infection can lead to severe complications such as:
A physical and pelvic exam will be done. The diagnosis is most often based on fever, rash, low blood pressure, and problems affecting multiple body systems.
Your bodily fluids and tissues may be tested. This can be done with:
The goal of treatment is to support life and reverse the process of organ decline. You may need to be monitored in the intensive care unit.
Cleaning and Draining the Infection Site
The wound will be opened. Sterile saline will be poured over the wound to clean the area. Any packing from a previous procedure will be removed.
If a birth control device is in the vagina, it will be taken out. If the TSS is menstrual type, the vagina may be flushed with saline.
To support your body while you heal:
You can decrease your risk of menstrual-associated TSS with the following steps:
Most other forms of the disease are not currently preventable.
American Congress of Obstetricians and Gynecologists
Centers for Disease Control and Prevention
The Society of Obstetricians and Gynaecologists of Canada
Women's Health Matters
Imöhl M, van der Linden M, Reinert RR, Ritter K. Invasive group A streptococcal disease and association with varicella in Germany, 1996-2009. FEMS Immunol Med Microbiol. 2011 Jun;62(1):101-109.
Tampons and asbestos, dioxin and toxic shock syndrome. United States Food and Drug Administration website. Available at:
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Updated March 20, 2013. Accessed January 22, 2015.
Toxic shock syndrome. Kids Health—Nemours Foundation website. Available at:
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Updated June 2014. Accessed January 22, 2015.
Tyner HL, Schlievert PM, Baddour LM. Beta-hemolytic streptococcal erythroderma syndrome: a clinical and pathogenic analysis. Am J Med Sci. 2011 Aug 11.
Last reviewed January 2015 by David L. Horn, MD, FACP
Last Updated: 6/20/2014
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