Toxic shock syndrome (TSS) is a rare but very serious infection. TSS is a medical
emergency. So it's important to know how to prevent it and what signs to watch for.
With prompt treatment, it's usually cured.
What Are the Signs & Symptoms of Toxic Shock Syndrome?
Toxic shock syndrome starts suddenly, often with
a high fever (temperature at least 102°F [38.8°C])
a rapid drop in blood pressure (with lightheadedness or fainting)
sunburn-like rash on any part of the body, including the palms of the hands and
the soles of the feet
Other signs include:
peeing less than usual
A person also might have bloodshot eyes and an unusual redness under the eyelids
or inside the mouth (and in the vagina in females). The area around an infected wound can become swollen, red, and
What Causes Toxic Shock Syndrome?
Toxic shock syndrome is caused by two types of
Staphylococcus aureus (often called staph)
Streptococcus pyogenes (often called strep)
Most cases are related to staph bacteria. When strep causes toxic shock syndrome,
it's usually because the bacteria got into areas of injured skin, such as cuts
and scrapes, surgical wounds, and even chickenpox blisters.
Who Gets Toxic Shock Syndrome?
Originally, toxic shock syndrome was linked to the use of super-absorbent tampons.
Research led to better tampons and better habits for using them, such as changing
them often. The number of TSS cases dropped dramatically. Today about half of all
TSS cases are related to menstruation.
Two birth control methods, the contraceptive sponge and the diaphragm,
have been linked to TSS.
Toxic shock syndrome also can affect someone with any type of staph infection,
Organs such as the liver and kidneys may begin to fail.
Problems such as seizures, bleeding, and heart failure can happen.
How Is Toxic Shock Syndrome Diagnosed?
If doctors think someone has toxic shock syndrome, they'll start intravenous (IV)
fluids and antibiotics as soon as possible, even before they're sure the person has
To confirm a diagnosis, doctors take a sample from the likely site of the infection,
such as the skin, nose, or vagina, to check for the bacteria. They also may take and
test a blood sample. Other blood tests can help doctors:
see how organs like the kidneys are working
check for other diseases that might be causing the symptoms
How Is Toxic Shock Syndrome Treated?
and IV fluids, as needed doctors will:
remove tampons, contraceptive devices, or wound packing
drain a pocket of infection (an abscess)
People with TSS usually need to stay in the hospital, often in the intensive care
unit (ICU), for several days. There, doctors can watch their blood pressure and breathing
and check for signs of other problems, such as organ damage.
Can Toxic Shock Syndrome Be Prevented?
Washing hands well and
often can help prevent the bacteria that cause toxic shock syndrome from spreading.
During their periods, girls can reduce their risk of TSS by:
washing their hands well before and after inserting a tampon
not using tampons or alternating
them with sanitary napkins
if using tampons, choose ones with the lowest absorbency that will handle menstrual
flow, and change the tampons often
on low-flow days, using pads instead of tampons
Between menstrual periods, store tampons away from heat and moisture, where bacteria
can grow (for example, in a bedroom rather than in a bathroom closet).
Any female who has had TSS should not use tampons.
Clean and bandage all skin wounds as quickly as possible. Call your doctor if a
wound gets red, swollen, or tender, or if a fever begins.
When Should I Call the Doctor?
Symptoms of toxic shock syndrome come on suddenly. Call your doctor right away
if you get a sudden high fever, feel faint, or have any other signs of TSS.