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May 23, 2012
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Toxic Shock Syndrome


Topic Overview

What is toxic shock syndrome?

Toxic shock syndrome (TSS) is a rare illness that happens suddenly after an infection. It quickly can harm several different organs, including the lungsClick here to see an illustration., kidneysClick here to see an illustration., and liverClick here to see an illustration., and it can be deadly. Since toxic shock syndrome gets worse quickly, it requires medical treatment right away.

What causes toxic shock syndrome?

An infection caused by strep or staph bacteria can lead to toxic shock syndrome. These bacteria are common and usually don't cause problems. But they make toxins that can cause toxic shock syndrome. In rare cases, the toxins enter the bloodstream and cause a severe immune reaction. This reaction causes the symptoms of TSS.

  • Strep toxic shock syndrome most often occurs after childbirth, the flu (influenza), chickenpox, surgery, minor skin cuts or wounds, or injuries that cause bruising but may not break the skin.
  • Staph toxic shock syndrome most often occurs after a tampon is kept in too long (menstrual TSS) or after surgery (nonmenstrual TSS).

What are the symptoms?

Toxic shock symptoms get worse quickly and can be deadly within 2 days. Having sudden, severe symptoms is one of the most important clues that you may have toxic shock syndrome. Get help right away if you have:

  • Sudden fever over 102°F (38.9°C).
  • Signs of shock, including low blood pressure and rapid heartbeat, nausea, vomiting, or fainting or feeling lightheaded, restless, or confused.
  • A rash that looks like a sunburn. The rash can be over several areas of your body or just in certain places, such as the armpits or the groin.
  • Severe pain in an infected wound or injury.

Other TSS symptoms include:

  • Severe flu-like symptoms, such as muscle aches and pains, stomach cramps, a headache, or a sore throat.
  • Redness inside the nose and mouth.
  • Pinkeye (conjunctivitis).
  • Scaling, peeling skin, especially on the palms of the hands and soles of the feet.

Symptoms may depend on whether staph or strep bacteria caused the infection.

If you think you have TSS, call your doctor right away. If you have symptoms of shock, such as severe weakness, dizziness, or lightheadedness, get emergency medical care right away.

How is toxic shock syndrome diagnosed?

Because toxic shock syndrome gets worse so quickly, it usually is diagnosed and treated based on symptoms, without waiting for lab test results. Tests can help show whether staph or strep bacteria are causing the infection.

Tests you may need include:

  • Blood tests.
  • Tests on body fluids or tissues.
  • Chest X-ray.
  • Tests to rule out other infections.

How is it treated?

Since toxic shock syndrome can be deadly, treatment almost always takes place in a hospital. To treat toxic shock syndrome, your doctor may:

  • Remove the source of the infection or clean the wound.
  • Treat complications, such as shock or organ failure.
  • Give you antibiotics.

If you don't have major complications, you most likely will get better in 1 to 2 weeks.

How can you prevent toxic shock syndrome?

You can take steps to prevent TSS:

  • Avoid using tampons and barrier contraceptives (such as diaphragms, cervical caps, or sponges) during the first 12 weeks after childbirth.
  • Follow the directions on package inserts for tampons, diaphragms, or contraceptive sponges. Change your tampon at least every 8 hours, or use tampons for only part of the day. Do not leave your diaphragm or contraceptive sponge in for more than 12 to 18 hours.
  • Keep all skin wounds clean to help prevent infection.
  • Help keep children from scratching chickenpox sores by managing itching.
  • If you have had menstrual TSS, do not use tampons, barrier contraceptives, or an intrauterine device (IUD).

Frequently Asked Questions

Learning about toxic shock syndrome:

Being diagnosed:

Getting treatment:

Ongoing concerns:

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eMedicineHealth Medical Reference from Healthwise

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