What is Toxic Shock Syndrome?

While uncommon, toxic shock syndrome is a life-threatening condition caused by bacteria such as staphylococcus aureus and group A streptococcus (streptococcus pyogenes). Toxic shock syndrome can affect men, women and children however in the past the condition was most commonly associated with the use of superabsorbent tampons. The condition in menstruating women has since declined since the discontinuation of certain tampon types.

Toxic Shock Syndrome  Risk Factors

While most cases of toxic shock syndrome affect menstruating women, it can occur in men, older, non-menstruating women and children and is associated with the presence of multiple factors.

The presence of a cut or burn, recent surgery, use of contraceptive sponges, diaphragms or superabsorbent tampons, childbirth, surgical wound, nasal packing and the presence of a viral infection all can predispose you to developing toxic shock syndrome. If you experience any of the symptoms listed in the section below, contact your healthcare provider immediately as complications of the condition can lead to shock, renal failure and even death.

Toxic Shock Syndrome Symptoms

It is important that you contact your healthcare provider right away if you experience any symptoms which could be related to toxic shock syndrome, especially in the event of recent tampon use, or a skin/wound infection. Most will display mild symptoms two- to-three days prior to developing toxic shock syndrome and may include the presence of a low –grade fever, muscle aching, chills and/or an overall feeling of general discomfort, uneasiness or ill health referred to as malaise.

Symptoms of toxic shock syndrome include:

  • Sudden onset of a high fever, greater than 102 degrees F (38.9 C)
  • Hypotension (low blood pressure/systolic <90mm Hg)
  • Nausea, vomiting or diarrhea
  • Sunburn type rash most concerning on the palms of the hands and soles of the feet. The rash is flat and when pressed turns white.
  • Confusion
  • Aching muscles
  • Red eyes, lips, mouth, tongue and throat
  • Sore throat
  • Cough
  • Abdominal pain
  • Lightheadedness, fainting and/or confusion/disorientation
  • Headaches (very common symptom)
  • Seizures

Toxic Shock Syndrome Diagnosis and Treatment

Your healthcare provider may utilize several testing modalities to determine the presence of a staphylococcus aureus and group A streptococcus infection and may include:

  • Blood samples to evaluate blood counts, electrolytes and organ function such as liver and kidney function.
  • Urine samples
  • Pelvic exam
  • Vaginal and/or cervical samples
  • Throat swab samples
  • CT scan
  • Lumbar puncture
  • Chest X-ray
  • Electrocardiogram (ECG)
  • Tests to exclude other medical conditions, for example, Rocky Mountain spotted fever and measles

Toxic shock syndrome must be treated in a timely manner for the best chances of survival. Treatment of the condition includes the use of antibiotics to treat the infection, possible use of medication to stabilize your blood pressure, fluids for hydration, electrolyte correction, and/or other treatment modalities dependent on your symptoms. Doctors will attempt to remove the potential source of the infection such as a tampon, nasal packing, etc. Dialysis may be required if the infection has severely affected your kidneys and at times, some may need the assistance of a ventilator to breathe. In certain situations surgery may be necessary to treat the infection, drain the area and/or remove dead tissue from the area.


  1. Toxic Shock Syndrome. Mayo Clinic.
  2. Toxic Shock Syndrome. E Medicine Health.
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