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Toxic Shock Syndrome

What is toxic shock syndrome?

Toxic shock syndrome is a rare but serious medical condition caused by a bacterial infection. It is caused when the bacterium Staphylococcus aureus gets into the bloodstream and produces toxins.

Although toxic shock syndrome has been linked to superabsorbent tampon use in menstruating women, this condition can affect men, children, and people of all ages.

Symptoms of toxic shock syndrome

Symptoms of toxic shock syndrome can vary from person to person. In most cases, symptoms appear suddenly. Common signs of this condition include:

When to see a doctor

You might attribute symptoms of toxic shock syndrome to another medical condition, such as the flu. If you experience the above symptoms after using tampons or after a surgery or skin injury, contact your doctor immediately.

Causes of toxic shock syndrome

Infection usually occurs when bacteria enter your body through an opening in your skin, such as a cut, sore, or other wound. Experts are not sure why tampon use sometimes leads to the condition. Some believe that a tampon left in place for a long period of time attracts bacteria. Another possibility is that tampon fibers scratch the vagina, creating an opening for bacteria to enter your bloodstream.

Risk factors for toxic shock syndrome

Risk factors for this condition include a recent skin burn, skin infection, or surgery. Other risk factors may include:

Toxic shock-like syndrome

A different but similar condition can result from toxins produced by the group A Streptococcus (GAS) bacterium. This is sometimes referred to as streptococcal toxic shock syndrome or toxic shock-like syndrome (TSLS).

The symptoms and treatment for this syndrome are nearly identical to those of toxic shock syndrome. However, TSLS is not associated with tampon use.

People who are at greater risk for a GAS infection are also more likely to develop TSLS. Your risk may be increased if you have:

How to diagnose toxic shock syndrome

Your doctor may make a diagnosis of toxic shock syndrome based on a physical examination and your symptoms. Additionally, your doctor may check your blood and urine for traces of Staphylococcus or Streptococcus bacteria.

Your doctor may also do a blood test to check your liver and kidney function. They may also take swabs of cells from your cervix, vagina, and throat. These samples are analyzed for the bacteria that cause toxic shock syndrome.

Treatment for toxic shock syndrome

Toxic shock syndrome is a medical emergency. Some people with the condition have to stay in the intensive care unit for several days so that medical staff can closely monitor them. Your doctor will most likely prescribe an intravenous (IV) antibiotic to help you fight the bacterial infection in your body. This will require the placement of a special IV line called a peripherally inserted intravenous catheter, or PICC line. You will receive 6–8 weeks of antibiotics at home. If this is the case, an infectious disease doctor will closely monitor you.

Other treatment methods for toxic shock syndrome vary depending on the underlying cause. For example, if a vaginal sponge or tampon triggered toxic shock, your doctor may need to remove this foreign object from your body. If an open wound or surgical wound caused your toxic shock syndrome, the doctor will drain pus or blood from the wound to help clear up any infection.

Other possible treatments include:

  • medication to stabilize blood pressure
  • IV fluids to fight dehydration
  • gamma globulin injections to suppress inflammation and boost your body’s immune system

Complications of toxic shock syndrome

Toxic shock syndrome is a life-threatening medical condition. In some instances, toxic shock syndrome can affect major organs in the body. If left untreated, complications associated with this disease include:

  • liver failure
  • kidney failure 
  • heart failure
  • shock, or reduced blood flow through the body

Signs of liver failure may include:

  • yellowing of the skin and eyeballs (jaundice)
  • upper abdominal pain
  • difficulty concentrating
  • nausea
  • vomiting
  • confusion
  • sleepiness

Signs of kidney failure may include:

  • fatigue
  • weakness
  • nausea and vomiting
  • muscle cramps
  • hiccups
  • persistent itching
  • chest pain
  • shortness of breath
  • high blood pressure
  • sleep problems
  • swelling in the feet and ankles
  • problems urinating

Signs of heart failure may include:

Outlook for toxic shock syndrome

Toxic shock syndrome is a medical emergency that can cause death if untreated. Call an ambulance or go to the emergency room if you suspect that you have symptoms of toxic shock syndrome. Prompt treatment can prevent major organ damage.

How to prevent toxic shock syndrome

Certain precautions can reduce your risk of developing toxic shock syndrome. These precautions include:

  • changing your tampon every four to eight hours
  • wearing a low-absorbency tampon or sanitary napkin during menstruation
  • using a reusable silicone menstrual cup and cleaning your hands thoroughly when changing it
  • wearing a sanitary napkin on light-flow days
  • washing your hands frequently to remove any bacteria
  • keeping cuts and surgical incisions clean and changing dressings often

Do not wear tampons if you have a personal history of toxic shock syndrome. This disease can recur. 

Content licensed from:

Written by: Valencia Higuera
Medically reviewed on: Jul 06, 2016: Carissa Stephens, RN, BSN, CCRN, CPN

This feature is for informational purposes only and should not be used to replace the care and information received from your health care provider. Please consult a health care professional with any health concerns you may have.
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