Toxic Shock Syndrome

There are two kinds of toxic shock syndrome: the most common is caused by Staphylococcus aureus, a bacteria that usually lives inside the nose, but can be found anywhere on the human body. Introduced into the wrong places, Staphylococcus can cause anything from boils, to urinary tract infections, to meningitis and pneumonia. If it enters the blood stream, the bacteria will release superantigens, which cause numerous illnesses, including toxic shock syndrome.

Streptococcus bacteria, the same bacteria that cause strep throat and flesh eating disease, can also cause another form of TSS. While having strep throat does not put you at risk for TSS, if streptococcus bacteria invades the bloodstream, through a break in the skin, such as a cut, burn or chicken pox blister, toxic shock could be the result.

How Common is TSS?

Fortunately, toxic shock syndrome occurs extremely infrequently. The average number of cases per year in the U.K. is 40. Out of those people, it’s likely that half of the cases will be severe enough to end in death. Left untreated, toxic shock syndrome is almost always fatal.

Who Can Get TSS?

Toxic shock is most associated with menstruating women using tampons, but anyone of any age can get toxic shock syndrome; women, men and children.


The symptoms of toxic shock can include:

  • Vomiting
  • A sudden, red rash, usually on the face, or the vulva on females
  • Dizziness, feeling faint or fainting
  • Sudden fever
  • Confusion
  • Muscle aches
  • Diarrhoea
  • Shock
  • Low blood pressure
  • Peeling skin
  • Sore throat

If you, or someone you know, experience these symptoms, it is important to seek medical help immediately. Left untreated, TSS is fatal.


The first course of action for doctors presented with a case of toxic shock syndrome is to remove any foreign materials, such as a tampon, that could be the cause of the infection. Any infected abscesses will be drained, and a course of antibiotics will usually be prescribed. Occasionally, dialysis may be needed if the TSS impaired kidney functions. The patient will need to be monitored for a period of time, to make sure that they do not go into shock and that they are improving.


Even though only half of all toxic shock syndrome cases are caused by tampon use, it is still important to maintain good tampon usage practices. It is believed that tampons can cause toxic shock because they provide a warm, moist environment where bacteria can thrive. In order to reduce the chances of TSS, it is important to wash your hands before and after inserting a tampon, change tampons frequently (every four to six hours), alternate between pads and tampons if possible and use the lowest absorbency possible for your flow.

In the 1980s there was a rash of TSS cases, due to the introduction of a high absorbency tampon that has since been taken off the market. Women under 30 should be especially vigilant as their bodies have had less time to build up a tolerance to staphylococcus bacteria.

It is important to maintain good hygiene. Wash your hands frequently with warm water and soap. A 30 second scrub and a 30 second rinse should be sufficient to remove a significant amount of bacteria.

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