Toxic Shock Syndrome

What is toxic shock syndrome?

Toxic shock syndrome (TSS) is a serious, and even life-threatening, staph (Staphylococcus aureus) infection. It is caused by bacteria that multiplies quickly and eventually leads to organ failure. Staph bacteria can be found in a young girl or woman’s vagina. If the bacteria becomes bad enough, it could enter your bloodstream and become toxic shock syndrome.

Toxic shock syndrome is a serious infection and leads to death in 50% of cases; even survivors can get the infection again.

What are the symptoms of toxic shock syndrome?

A fever of 102°F or higher is a warning sign for anyone who is at risk for toxic shock syndrome. Symptoms might include:

  • headache
  • vomiting
  • low blood pressure
  • confusion
  • diarrhea
  • red rash on the palms of your hands or bottom of your feet

If you or your child has symptoms of toxic shock syndrome, go to the emergency room right away. The infection can get worse quickly and cause organ failure, or even death.

What causes toxic shock syndrome?

Toxic shock syndrome gained national attention in the late 1970s as an infection tied to tampon use during a woman’s period. Although newer research shows using a tampon for longer than the recommended time without changing it can create the perfect environment for a staph infection, the use of a tampon is not the only way. The same danger exists with certain birth control devices when they are used longer than the recommended time.

Not every staph infection leads to toxic shock syndrome. With tampon use, many researchers believe that inserting a tampon can scratch the vagina and make it vulnerable to an infection. They also think tampons made with artificial fibers are more likely to trap bacteria than tampons made with 100% cotton.

Toxic shock syndrome can also occur for other reasons. It can occur when a wound from a burn or surgery doesn’t heal properly, from a skin infection, just after childbirth and even in the case of a serious nosebleed that packs medical gauze to stop it. For this reason, toxic shock syndrome can affect men and children too.

How is toxic shock syndrome diagnosed?

There is no rapid test for toxic shock syndrome. Doctors can test for staph bacteria using a blood sample or a sample taken from an infected wound. However, relying on that alone takes too long when your body is in distress. Doctors usually diagnose toxic shock syndrome based on symptoms such as a high fever, low blood pressure, and a rash.

Can toxic shock syndrome be prevented or avoided?

If you are a woman who wants to continue using tampons, you can reduce your risk of toxic shock syndrome by using tampons carefully. Doctors suggest that you should do the following during your period:

  • Alternate between tampons and pads so you don’t create an environment for the bacteria to grow.
  • Avoid using high-absorbency tampons.
  • Change your tampon frequently, as recommended on the package.
  • On the lighter days of your period, use pads instead of tampons.

If you have an open wound or burn, be sure it is properly cleaned and watch for signs of infection (for example, redness, swelling, or pus). Ask your doctor how you should take care of the wound or burn to avoid getting a staph infection.

Toxic shock syndrome treatment

Because toxic shock syndrome gets worse quickly, you may be seriously ill by the time you reach the emergency room. Once there, the medical staff will start an IV to give you fluids, antibiotics, and blood pressure medicine. If your kidneys are failing, you also may be given blood plasma and kidney dialysis. If you are a woman who has a tampon, diaphragm, sponge, or cervical cap in place, it will be removed. If your infection is due to an infected wound, the wound will be cleaned thoroughly. Once you are stable, you will be moved to the intensive care unit for monitoring.

Living with toxic shock syndrome

There may be significant challenges if you survive the initial infection. This may include recovering from being on life support, or from organ failure.

Questions to ask your doctor

  • How long is too long to wear a tampon or certain birth control devices?
  • Are there any health conditions that increase my risk of getting a bacterial infection that leads to toxic shock syndrome in a wound?