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Toxic Shock Syndrome

Toxic shock syndrome (TSS) made the news in the late 1970s and early 80s when it was found that many people who developed TSS had used certain brands of super-absorbent tampons. These were later taken off the market. However, although TSS is rare, it is still a problem associated with infections, such as cellulitispneumonia or osteomyelitis.

Toxic shock syndrome occurs when certain bacteria release toxins into the body. Although TSS can be caused by group A streptococcus (strep) bacteria, it is usually caused by Staphylococcus aureus (staph) bacteria. These can lead to sepsis and septic shock.

Sometimes incorrectly called blood poisoning, sepsis is the body’s often deadly response to infection. Like strokes or heart attacks, sepsis is a medical emergency that requires rapid diagnosis and treatment. Sepsis and septic shock can result from an infection anywhere in the body, such as pneumonia, influenza, or urinary tract infections. Like strokes or heart attacks, sepsis is a medical emergency that requires rapid diagnosis and treatment. Worldwide, one-third of people who develop sepsis die. Many who do survive are left with life-changing effects, such as post-traumatic stress disorder (PTSD), chronic pain and fatigue, organ dysfunction (organs don’t work properly) and/or amputations.

Toxic shock syndrome symptoms

The symptoms of TSS start very suddenly:

  • High fever: 102 degrees Fahrenheit (38.8 degrees Celsius) or higher
  • Fainting
  • Rapid drop in blood pressure
  • Confusion
  • Diarrhea
  • Fatigue
  • Headache
  • Low urine output
  • Overall muscle pain
  • Red eyes
  • Seizures
  • Sunburn-like rash, especially on the palms of the hands and soles of the feet
  • Thirst
  • Vomiting
  • Weakness

Risk factors

Anyone can develop TSS, but some people may be at higher risk, such as those who:

  • Have cuts or wounds on the skin, or have had surgery
  • Have a viral infections, such as chicken pox
  • Use contraceptive sponges, diaphragms, or super-absorbent tampons
  • Recently had a child, miscarriage, or abortion
  • Have had TSS before

Preventing toxic shock syndrome

Toxic shock syndrome is not always preventable, but you can take some steps to reduce your risk of developing it.

  • Keep cuts, wounds, and incisions as clean as possible, perhaps using antibacterial ointments, as directed by your doctor.
  • Watch all cuts, wounds, and incisions for signs of infection (increasing pain, redness around the wound, pus or other discharge from the wound).
  • Change tampons frequently and use the lowest absorbency possible.
  • Use menstrual pads instead of tampons for light flow days.
  • Remove diaphragms and contraceptive sponges as quickly as possible.

Diagnosis and treatment

Because the symptoms for TSS occur so quickly, it’s vital that they be recognized, and TSS diagnosed and treated as quickly as possible. Blood tests will be done to find out what type of bacteria caused the TSS. Other tests, such as swabs from parts of your body that could be infected, urine tests, CT scans, and lumbar punctures may also be done.

The treatment for TSS is the same as for septic shock. If the cause of the infection is removable (tampon, wound packing, etc.), this will be done right away. The doctors will order intravenous (IV) fluids and antibiotics to start fighting the infection right away. Other treatments may include:

  • Medications for blood pressure: If your blood pressure is too low, you might need medications to bring it back up.
  • Dialysis: If your kidneys have stopped working, you may need dialysis until your kidneys can do their job again.
  • Oxygen: You may have an oxygen mask that delivers oxygen to help you breathe better.
  • Ventilator: If you have trouble breathing, you may need intubation (a tube placed in your trachea) and a ventilator, or breathing machine.
  • Surgery: If necessary, a surgeon will operate to remove infected or gangrenous tissue that is causing the TSS.

If you suspect sepsis, call 9-1-1 or go to a hospital and tell your medical professional, “I AM CONCERNED ABOUT SEPSIS.” 

The information here is also available as a Sepsis Information Guide, which is a downloadable format for easier printing.

Would you like to share your story about sepsis or read about others who have had sepsis? Please visit Faces of Sepsis, where you will find hundreds of stories from survivors and tributes to those who died from sepsis.

Updated November 3, 2021.

Read Personal Stories of Sepsis and Toxic Shock Syndrome

Teddy Bennett

Survivor

My story of Strep A, toxic shock and sepsis. My 11-month-old son Teddy became ill in October 2018 around Halloween. I took him to the GP twice, then to a walk-in centre. He was admitted to hospital via ambulance for observation and then discharged a few hours later. I took him back to the hospital the following morning as I knew something was not right. He was observed again and then discharged with a district nurse attending our home the following morning. Teddy was then rushed in via ambulance, he had become severely unwell. The team struggled access veins, after ... Read Full Story

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Steven Keske

Survivor, Survivor

In April 2020 my son came to me and said his leg hurt. I coughed it up to growing pains. The next morning he woke up to a rash and a fever. He said he leg hurt. Called his doctor and was referred to urgent care. The urgent care doctor said it was a virus and let it take its course. And do Google Covid testing sites. Within 24hrs I found my son’s lifeless body, I rushed him to the children’s hospital and that’s when we found out what he really had. If I didn’t check on him that night ... Read Full Story

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Laura Lafollette

Survivor, Survivor, Survivor

Five months ago my life changed forever. I awoke unable to walk, talk, and as my blood pressure bottomed, my face turned purple then blue. I was rushed to the ER where they discovered my IUD caused me to develop toxic shock syndrome and DIC. (Sepsis and Toxic Shock Syndrome, Sepsis and DIC) These deadly bacteria gave me a 1% chance of survival. I was transferred to another hospital to have both hands amputated. (Sepsis and Amputations) I then spent another 10 days. During the worldwide corona virus. I went through all this alone no one could come in or ... Read Full Story

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Natasha N

Survivor, Survivor, Survivor, Survivor

In June 2020, I had a uterine outpatient procedure that was pretty standard. I had already gone through a bit of a frustrating time with my OBGYNS with IUD pain and abnormal bleeding, so I was glad to finally have some answers, even though frustrating and traumatic. I was given antibiotics post-procedure and felt fine the next two days. My boyfriend and I were on a road trip when I starting feeling very uncomfortable in the car and slight cramps. I was told this was a potential side effect of the procedure so I thought nothing of it. We get ... Read Full Story

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Mark Allen

Survivor, Survivor, Survivor, Survivor, Survivor

My story starts on Saturday, June 23, 2018, when I started developing a slight fever, for what I thought, at the time, was a standard virus or cold. I continued treating Saturday as such, and switching back and forth between Tylenol and ibuprofen to break the fever with plenty of rest. However, Sunday night my fever returned and would not go away. On Monday, June 25, I contacted my primary care physician to schedule an appointment for his next available day, which would be on Tuesday, June 26. Sensing something was wrong, I went to an urgent care who recommended ... Read Full Story

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Toxic Shock Syndrome

Toxic shock syndrome (TSS) made the news in the late 1970s and early 80s when it was found that many people who developed TSS had used certain brands of super-absorbent tampons. These were later taken off the market. However, although TSS is rare, it is still a problem associated with infections, such as cellulitispneumonia or osteomyelitis.