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Toxic Shock Syndrome

Toxic Shock Syndrome (TSS) is a serious but uncommon bacterial infection. Originally it was linked to the use of tampons, but is also known to be associated with the contraceptive sponge and diaphragm. In rare cases, TSS has resulted from wounds or surgery incisions where bacteria have been able to enter the body and cause the infection.

There are 2 different types of this condition:

TSS, caused by the staphylococcus aureus bacteria. The latter has been associated with tampons. The exact connection is still not clear, but it is believed by researchers that certain high-absorbency tampons provide a moist, warm home where the bacteria can thrive.

TSS can affect anyone who has any type of staph infection, including pneumonia, a blood infection called septicemia or a bone infection called osteomiŽlitis, but it usually occurs in menstruating women.

A related infection, STSS or streptococcal toxic shock syndrome, is caused by streptococcus bacteria. It most often appears after streptococcus bacteria have invaded areas of injured skin, for instance cuts and scrapes, surgical wounds and even chickenpox blisters. However, it almost never follows a simple streptococcus throat infection, commonly known as strep throat.


  • Sudden vomiting.
  • High fever, at least 38.8.
  • Rapid drop in blood pressure.
  • Watery diarrhea.
  • Sore throat.
  • Muscle aches.
  • Sunburn-like rash appears after 24 hours.
  • Eyes may become bloodshot.
  • Unusual redness under the eyelids or inside the mouth (and vagina in females). ∑ Broken blood vessels can appear on the skin.

Other symptoms may include mental changes or confusion; decreased urination; fatigue and weakness; thirst; weak and rapid pulse; pale and moist skin; and rapid breathing.


Can happen, following a streptococcus infection in the body, in most cases a skin infection or infected wound within 48 hours:

  • Blood pressure drops dangerously low;
  • There may be fever, dizziness, confusion;
  • Difficulty breathing, weak and rapid pulse;
  • Skin may be pale and moist;
  • There may be a blotchy skin rash that sometimes peels;
  • Area around the infected wound can become swollen, red and have areas of severely damaged or dying flesh;
  • Liver and kidneys may begin to fail;
  • Bleeding problems may develop.


TSS may be deadly in up to 55% of cases, and the conditions may return in those who survived.


  • Severe organ dysfunction;
  • Kidney failure;
  • Heart failure;
  • Liver failure;
  • Shock.


  • Hand washing is extremely important, as the bacteria causing TSS can be carried on unwashed hands.
  • Females must either avoid using tampons or alternating them with sanitary napkins to reduce the risk of TSS.
  • If only tampons are used, it is important to use tampons with a low absorbency.
  • Tampons should be changed regularly Ė every 4 to 6 hours.
  • Store tampons away from heat and moisture (where bacteria can grow).
  • A female recovering from TSS should check with her doctor before using tampons again.
  • Bandage and clean all skin wounds as quickly as possible.
  • See a doctor immediately if a wound becomes red, swollen tender or if a fever develops.
  • Don't use tampons with plastic applicators.

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