What is toxic shock syndrome?

Toxic shock syndrome, also known as TSS, is a rare condition caused by staph, strep or clostridium sordellii bacteria. About half the cases of toxic shock syndrome occur in women of menstruating age; the rest occur in older women, men and children.

Causes of toxic shock syndrome

Toxic shock syndrome is caused by three types of bacteria — staphylococcus aureus (staph) bacteria, clostridium sordellii or group A streptococcus (strep) bacteria. In rare conditions, the bacteria, which can live on your skin or mucous membranes, can start to grow and produce potentially deadly toxins. Absorbent tampons can cause bacteria to become trapped in the vagina and enter the uterus. Bacteria can also make tiny cuts in the vagina wall where bacteria can directly enter the bloodstream.

Risks factors for toxic shock syndrome

Most cases of toxic shock syndrome involve the use of absorbent tampons. If you use tampons during your menstruation period, you are at greater risk for developing toxic shock syndrome. Women ages 15-25 are at highest risk.

Other factors that increase your likelihood of developing TSS include patients who have:

  • Skin wounds
  • Surgical incisions
  • Nasal packing
  • Burns
  • Undergone a recent gynecologic procedure such as childbirth

Symptoms of toxic shock syndrome

Symptoms of toxic shock syndrome include:

  • Sudden fever
  • Hypotension (low blood pressure)
  • Nausea and vomiting
  • Watery diarrhea
  • Dizziness
  • Eye redness
  • Rash on palms - typically resembling a sunburn
  • Muscle aches
  • Seizure
  • Headaches
  • Skin peeling on the soles of your feet or palm of your hands

You may not experience all of these symptoms. If you have multiple symptoms that indicate you have toxic shock syndrome, call your doctor right away.

Diagnosis of toxic shock syndrome

If you suspect you have toxic shock syndrome, get to the doctor right away. Your doctor will take a full medical history, check your blood pressure and order a blood test. The blood test will confirm the type of bacteria that is causing the infection in your body.

Women may also undergo a vaginal examination where your doctor will collect tissue samples to perform a tissue culture. The samples will be analyzed for bacteria that causes TSS. If you have a wound infection, your doctor may take a tissue sample at the wound site to evaluate the tissue for bacteria.

Treatment of toxic shock syndrome

If you have toxic shock syndrome, you will likely be hospitalized and given intravenous (IV) antibiotics. The antibiotics will control bacteria grown but can’t remove the potentially lethal toxins in the body. In severe cases, patients may need intravenous immune globulins. If your blood pressure is low, you will also need medications to raise your blood pressure.

You will likely need to be in the ICU for a few days for your doctor to monitor your blood pressure and your vital organs before moving to a regular hospital room.

Preventing toxic shock syndrome

The only way to completely avoid toxic shock syndrome associated with tampons is to not use them. For women who wear tampons, follow the following guidelines:

  • Change your tampons every four to eight hours. When your flow is heavy, rotate them even more often.
  • Use sanitary pads or other methods to collect your flow as often as possible. Potentially using alternative methods at night and every other day.
  • Avoid using absorbent tampons during your lowest flow — switch to a less absorbent option.
  • If you have had TSS previously, completely avoid tampons.
  • Closely follow instructions on using vaginal contraceptives and diaphragms.

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