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 2 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.
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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 related to tampons has since significantly decreased.
Factors that may increase the chances of TSS:
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. These may include:
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.
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:
To help reduce the chances of menstrual-associated TSS:
There are no current guidelines to prevent most other forms of the disease.
Centers for Disease Control and Prevention
The American Congress of Obstetricians and Gynecologists
The Society of Obstetricians and Gynaecologists of Canada
Women's Health Matters—Women's College Hospital
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;62(1):101-109.
Staphylococcal toxic shock syndrome . EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114492/Staphylococcal-toxic-shock-syndrome . Updated August 12, 2016. Accessed February 15, 2018.
Toxic shock syndrome. Kids Health—Nemours Foundation website. Available at:
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Updated June 2014. Accessed February 15, 2018.
Tyner HL, Schlievert PM, Baddour LM. Beta-hemolytic streptococcal erythroderma syndrome: a clinical and pathogenic analysis. Am J Med Sci. 2011;342(4):343-344.
Last reviewed March 2018 by
EBSCO Medical Review Board
David L. Horn, MD, FACP
Last Updated: 6/20/2014