Toxic shock syndrome, abbreviated as TSS, is a rare, potentially life-threatening disorder. It occurs when toxins made by certain types of bacteria are released into the bloodstream.
Toxic shock syndrome was first described in children in 1978. Experts quickly realized that it happened more often among women who used superabsorbent tampons during their periods. TSS is triggered by toxins made by Staphylococcus aureus bacteria. The toxins cause a high fever and can damage the kidneys, liver, and heart.
Experts believe that tampons may trap bacteria within the vagina. The moist, humid environment allows them to grow and produce high levels of toxins. Tampons can cause very small cuts in the vagina during insertion. These small cuts allow bacteria and their toxins to enter the bloodstream. About 70% of TSS cases have been related to certain brands of highly absorbent tampons that are no longer made.
TSS usually starts suddenly and develops quickly. The symptoms may include: confusiondiarrheadizziness or faintinga fever of 102 degrees Fahrenheit or higherheadachespelvic painsore throata sunburn-like rash anywhere on the body, but usually on the soles of the feet and palms of the handvomiting
Factors that increase a woman's chances of getting TSS: being between the ages of 12 and 30having recently delivered a babyhaving recently had surgeryleaving a diaphragm or cervical cap in the vagina for more than 36 hourswearing the same tampon for longer than 8 hours
A woman can lower her risk for TSS by taking these steps: Alternate tampons with pads every other day during the heaviest flow.Avoid or minimize the use of superabsorbent tampons.Change tampons at least every 6 to 8 hours.Use pads while sleeping.
Changes in the design of tampons have occurred because of concern over toxic shock syndrome. Changing tampons frequently should nearly eliminate the risk of tampon-related toxic shock syndrome.
Diagnosis of TSS begins with a history and physical exam, including a pelvic exam. The healthcare professional may order the following tests: blood culturescomplete blood count (CBC)kidney function testsliver function testsspinal tapthroat culturesurinalysisvaginal culture for
If severe shock has occurred and led to kidney, liver, lung, or heart damage, long-term consequences may require treatment or cause permanent disability. The three major causes of death related to severe TSS are as follows: disseminated intravascular coagulation, or DIC, which causes uncontrollable bleedingirreversible shocksevere lung damage
Toxic shock syndrome is not contagious and poses no risk to others.
A successful outcome depends on aggressive therapy. A severe TSS infection may require the following: antibiotics given through the veinblood transfusionscorticosteroidselectrolyte or salt replacements fluids and medications through the vein to maintain blood pressureuse of a ventilator if the lungs are damaged
Medications and blood transfusions may cause allergic reactions.
Roughly 30% of women who develop TSS get it again. It is most likely to recur during the first three periods a woman has after treatment. The second bout may be more or less severe than the initial one. Recurrences are less common if a woman gets treatment to eliminatebacteria during the initial infection. A woman should avoid tampons and sexual intercourse until the healthcare professional says otherwise.
Any new or worsening symptoms should be reported to the healthcare professional.