A rare but serious condition known as toxic shock syndrome (TSS) occurs when certain bacteria release toxins into the bloodstream. TSS can cause severe inflammation in the body, affecting several organs and systems at the same time. It is life-threatening and needs immediate medical attention.
Many types of bacteria can cause TSS, but Staphylococcus aureus (staph) and Streptococcus pyogenes (strep) are the most common. They normally live on the skin, in the nose, or in the vagina, and do not harm anyone. However, certain conditions can cause them to invade the body through wounds, cuts, burns, surgery, or tampons, releasing toxins that trigger TSS.
Anyone can develop TSS, but some factors increase the risk, such as:
Using superabsorbent tampons, menstrual cups, contraceptive sponges, or diaphragms
Having a skin wound, burn, or infection
Having had recent surgery or childbirth
Having a viral infection, such as the flu or chickenpox
Having a weakened immune system
TSS can develop suddenly and rapidly. The symptoms may vary depending on the type and source of the infection, but some common ones are:
High fever (above 38.9°C or 102°F)
Low blood pressure (hypotension)
Rapid heartbeat (tachycardia)
Nausea, vomiting, or diarrhea
Headache, muscle pain, or confusion
Rash that looks like a sunburn, especially on the palms and soles
Peeling of the skin, especially on the hands and feet
Redness or swelling of the eyes, mouth, or throat
Seizures or loss of consciousness
A doctor will diagnose TSS based on a patient's symptoms, medical history, and physical examination. Some tests may be ordered to confirm the diagnosis and identify the type and source of the infection, including:
Blood tests: To check for the presence of bacteria, toxins, or antibodies in the blood
Swab tests: To collect samples from the nose, throat, vagina, or cervix and culture them for bacteria
X-ray or CT scan: To look for signs of organ damage or infection in the chest, abdomen, or pelvis
TSS is a medical emergency and requires hospitalization and intensive care. The treatment aims to:
Stop the infection: Antibiotics are given intravenously to kill the bacteria and prevent them from producing more toxins
Support the vital functions: Fluids, electrolytes, and medications are given intravenously to maintain the blood pressure, heart rate, and oxygen levels
Remove the source of the infection: Any foreign objects, such as tampons, menstrual cups, or sponges, are removed from the body. Any infected wounds or abscesses are drained or surgically removed
Reduce the inflammation: Intravenous immunoglobulin (IVIG) is a treatment that contains antibodies from donated blood. It may help to neutralize the toxins and modulate the immune response
Treat the complications: Depending on the severity and extent of the organ damage, the patient may need additional treatments, such as dialysis, oxygen therapy, or surgery
TSS can be prevented by taking some simple measures, such as:
Changing tampons frequently (every 4 to 8 hours) and using the lowest absorbency possible
Alternating tampons with pads or liners during menstruation
Avoiding tampons or other devices if you have had TSS before or are allergic to them
Washing your hands before and after inserting or removing tampons or other devices
Keeping your skin clean and dry and treating any wounds or infections promptly
Seeking medical attention if you have signs or symptoms of TSS, especially if you have a risk factor
It is important to be aware of the causes, symptoms, diagnosis, treatment, and prevention of TSS, and to seek medical help as soon as possible if you suspect you might have it. TSS can be fatal, but most people can recover fully with prompt and proper treatment.
