What is toxic shock syndrome (TSS)?

Toxic shock syndrome (TSS) is a rare but potentially life-threatening condition that is caused by certain strains of bacteria that produce toxins (poisons). It can result in the failure of vital organs, such as the liver, lungs or heart. Toxic shock syndrome was first identified in 1978 when a group of children became ill with it. In the early 1980s, cases of toxic shock syndrome were reported among women who used superabsorbent tampons during their menstrual periods. However, women who are not menstruating, men, and children may also contract toxic shock syndrome. Fifty percent of cases are non-menstrual. Skin wounds, surgical incisions, nasal packing, burns or gynecological procedures can increase the risk of the condition.

What causes toxic shock syndrome (TSS)?

The three main types of bacteria that can cause toxic shock syndrome are staphylococcus aureus, clostridium sordelli and streptococcus pyogenes. In many cases, these bacteria live on the skin or on the mucous membranes without causing any ill effects. However, under certain conditions, some strains of bacteria may start to grow rapidly and produce toxins .

Staphylococcus aureus bacteria may become trapped in the vagina when highly absorbent tampons are used and can enter the uterus via the cervix. Bacteria may grow on tampons, especially if they are not changed often enough. Bacteria also may grow if superabsorbent tampons are used when the menstrual flow is light. Tampons can also cause tiny cuts in the vagina through which bacteria can enter the bloodstream.

What are the symptoms of toxic shock syndrome (TSS)?

The onset of symptoms is usually sudden. Symptoms of toxic shock syndrome may vary depending on the type of bacteria that are producing the toxins. They may include:

  • Nausea or vomiting.
  • Sudden high fever and chills.
  • Watery diarrhea.
  • Rash resembling a bad sunburn or red dots on the skin.
  • Dizziness, light-headedness or fainting.
  • Low blood pressure (hypotension).
  • Redness in the eyes (conjunctivitis).
  • Peeling of the skin on the soles of the feet or palms of the hands.

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