Toxic shock syndrome

condition caused by bacterial toxins

Toxic shock syndrome or TSS is a non-common, deadly infection caused by toxins from bacteria.

Toxic shock syndrome is usually caused by Staphylococcus bacteria, but it can also be caused by Streptococcus bacteria.



Symptoms of toxic shock syndrome can show up suddenly. The disease can be very deadly. The symptoms are different when it is caused by different bacteria. When it is caused by Staphylococcus aureus, the symptoms are generally high fever, low blood pressure, confusion, and malaise. If the disease is not treated, someone with toxic shock syndrome caused by Staphylococcus aureus can go into a coma.

When toxic shock syndrome is caused by Streptococcus pyogenes, it usually is a rash that was already there getting worse. People with toxic shock syndrome caused by Streptococcus pyogenes have pain where the rash is, then the following symptoms happen very quickly:

The symptoms of toxic shock syndrome include:

  • A high fever that starts quickly
  • Low blood pressure
  • A rash that looks like a sunburn, mostly on the palms of the hand and soles of the feet



Toxic shock syndrome can be caused by many things. The most common reasons are injuries to the skin that allow bacteria to get into the bloodstream, and tampons.



Many people with toxic shock syndrome have to stay in the hospital. If it is very bad, they might have to go to the intensive care unit. If the reason that they have toxic shock syndrome is because of tampon use, doctors will make sure that they take the tampon out. If the reason that they have toxic shock syndrome is an injury (an abscess or other infection), the injury has to be drained.

Antibiotics like cephalosporin, penicillin, and vancomycin are used to stop the bacteria from growing. Clindamycin and gentamicin stop the toxins from being produced.

Tampons and toxic shock syndrome


In 1978, Procter and Gamble (a United States company that sells many different products) started selling tampons called Rely. Rely tampons could be left in for a whole menstrual cycle, which is from 2 to 8 days. Women who used Rely tampons sometimes got toxic shock syndrome because of this.[1] Other tampons that are left in for a long time can also cause toxic shock syndrome.


  1. CDC 1980. "Toxic-shock syndrome--United States." MMWR 29(20):229-230.