Wonderful World of Pregnancy

How Can You Tell If You Have Toxic Shock Syndrome?

Toxic shock syndrome occurs rarely, but it can put the life of that actual person in danger. Find out how to recognize it and what mistakes lead to its occurrence!

How Can You Tell If You Have Toxic Shock Syndrome

How Common Is Toxic Shock Syndrome?

Toxic shock syndrome (TSS) is a rare, life-threatening condition that often occurs suddenly after an infection and can rapidly affect various organs, including the lungs, kidneys and liver. It progresses very rapidly, requiring immediate medical treatment.


Historically, in the late `70s, this syndrome was associated with super absorbency tampons. The development of new types of tampons as well as various campaigns for the education of women on how to use them, have led to a major decrease regarding these infections.

However, the most frequent cause of this condition, even in our present days, is an ignored tampon which isn`t removed at time or is completely forgotten until the infection starts to develop. Still, the causes of this illness aren`t limited to tampons. Other factors that may lead to TSS may include:

  • Contraceptive sponges.
  • Birth.
  • Dilation & curettage.
  • Skin infections caused by various illnesses (e.g. chickenpox).
  • Abortion.

Although the reasons for this particular syndrome vary, they are often similar and they should really be investigated by a physician as early as possible, so any severe issues can be avoided later.

What Are the Early Symptoms of Toxic Shock Syndrome?

The rapid development of the symptoms is among the most important signs for TSS.

Symptoms of septic shock syndrome vary in severity, depending on the streptococcus or staphylococcus involved.

General Symptoms of Septic Shock Syndrome

They include:

  • Flu-like symptoms, like muscle pain, abdominal cramps, headache, sore throat. These symptoms are common in a lot of affections, but the TSS symptoms are progressing faster and more severely than those caused by a less serious condition.
  • Fever over 38.8° C suddenly occurred.
  • Vomiting and diarrhea.
  • Sunburn-like disorder.
  • Shock signs, including low blood pressure and rapid ventricular pressure, fainting sensation, syncope, nausea, vomiting or agitation and confusion.
  • Conjunctivitis.
  • Pain around the infection`s area (if a skin lesion is involved).
  • More than 1 organ involved, usually the lungs and kidneys.
  • Disseminated blood infection throughout the body (sepsis).
  • Epidermal necrosis (skin tissue death), which occurs early in the evolution of the syndrome.
  • Peeling (exfoliating skin tissues), which occurs during the healing period.

Symptoms of Non-Menstrual Streptococcal TSS

The signs are developing rapidly:

  • In women who gave birth recently, from 2 – 3 days to a few weeks from childbirth.
  • In patients with infected surgical wounds, from 2 days to a week after surgical treatment.
  • In patients with respiratory infections, in 2 to 6 weeks after the onset of respiratory symptoms.

Symptoms of Staphylococcal Menstrual TSS

The symptoms occur after 3 – 5 days from the onset of the menstrual cycle, if the woman uses internal tampons.

Symptoms of Staphylococcal Non-Menstrual TSS

The signs occur in up to 12 hours after surgery.

Risk Factors

Some people are normally more susceptible to TSS, even in the absence of risk factors. These people have a deficiency of antibodies directed against the toxins of streptococci and staphylococci. Patients with immune system disorders, like diabetes, cancer or autoimmune diseases, are at greater risk for developing TSS because they don`t have a specific systemic immune response directed against toxins.

Risk Factors for Menstrual TSS

The long-term use of a tampon, especially one with a high absorption power, increases the risk of menstrual TSS. Patients with an episode of TSS have a high risk of recurrence.

Risk Factors for Non-Menstrual Streptococcal TSS

In children, varicella (chickenpox) is the most important risk factor for a streptococcal infection which can lead to TSS. Varicella vesicle damage through grating can lead to a group A streptococcal skin infection, increasing the risk for this syndrome to occur in children.

In adults, the risk factors are:

  • Recent childbirth.
  • Recent surgical abortion.
  • Skin lesions, like cuts, burns, bruises, insect and animal bites, ulcers determined by herpes zoster or chickenpox, mastitis (breast swelling), piercing and tattoos.
  • Flu.
  • Muscle infections, like myositis, or joint infections, like bursitis.
  • Recent respiratory infections, like sinusitis, sore throat (pharyngitis), laryngitis, tonsillitis or pneumonia.

Risk Factors for Non-Menstrual Staphylococcal TSS

The risk for non-menstrual staphylococcal toxic shock syndrome is increased by:

  • The use of contraceptive sponges, diaphragms or intrauterine devices.
  • Vaginal irritation and inflammation (vaginitis).
  • Skin lesions, including surgical wounds, especially nose surgery, when packing bandages are used.
  • Abscesses.
  • Recent respiratory infections, like sinusitis, sore throat, laryngitis, tonsillitis or pneumonia.
  • Historical staphylococcal menstrual shock syndrome.

Risk of Recurrence

After an episode of menstrual TSS, about 30% of patients will still have at least 1 more episode. After such an episode, the risk of recurrence is most likely higher for the first 3 menstrual cycles, especially if the initial infection hasn`t been eradicated with the appropriate antibiotic treatment. The eradication of this infection is particularly important, research showing that around 65% of patients don`t develop antibodies after menstrual TSS. Without antibodies, there is a vulnerability to bacterial toxins that cause TSS.

Patients with a history of TSS associated with the use of internal tampons might reduce the risk of recurrence avoiding the use of buffers as well as diaphragms, contraceptive sponges and intrauterine devices. Patients with a history of non-muscular TSS have an increased risk of recurrence, although this is rare.

Can Toxic Shock Syndrome Kill You?

TSS appears when a particular type of bacteria develops and produces toxins which poison the body. As already mentioned, although the condition is rare, it can lead to death of it isn`t treated.

Just about anyone might get this condition, but young women under up to 19 years old are more susceptible. Also, leaving the tampon in for over 8 hours and using super absorbency tampons may increase the risk of contracting this condition.

Can Toxic Shock Syndrome Be Sexually Transmitted?

Although technically isn`t classified as a STD, lots of the signs of TSS can easily be mistaken for those of real STDs. It`s rare but serious condition which frequently involves shock, fever, and issues with the right function of a few important organs.


When a patient that is experiencing TSS receives specialist advice, it`s required immediate medical treatment. Due to the fact that TSS can progress very fast and develop serious complications, the treatment is always done in the hospital where the patient can be carefully monitored. The treatment of the shock or organic insufficiencies will be necessary, usually, before the results of the investigations are made available. The transfer to intensive care is necessary when the patient has signs of shock or breathing difficulties (respiratory failure).

The treatment for staphylococcal or streptococcal TSS includes:

  • Removing the infection outbreak: if the patient uses an internal tampons, a diaphragm or a contraceptive sponge, they`ll be removed immediately; the infected wounds will be cleaned to disinfect the bacterial area; once the source of the infection is eliminated, the patient`s general condition improves rapidly.
  • Treatment the complications, including low blood pressure, shock and organic insufficiencies: the specific treatment depends on the type of problem that has occurred; large amounts of intravenous fluids are administered to replace the fluids lost through vomiting, diarrhea and fever, and to avoid the complications of hypotension and shock.
  • Antibiotics directed against the bacteria that cause TSS: clindamycin stops the production of toxins and is administered immediately to relieve the symptoms; Other drugs, like cloxacilin or cefazolin, might be added when staphylococci or streptococci are identified by lab tests. – Check for more!

When major complications don`t occur, most patients will be fully resuscitated within 1 – 2 weeks with antibiotic treatment. When identified and treated appropriately, staphylococcal TSS is severe, but rarely fatal (3% – 6%).

Streptococcal TSS has a fatality rate of 30% – 60%. This rate might be due to the fact that streptococcal TSS can be difficult to diagnose before serious complications occur, like blood infections or the development of a rare bacterium that can destroy the skin.


Menstrual toxic shock syndrome can be prevented by simply changing your internal tampon more often, at least every 8 hours. This way, you`ll be able to prevent any development of bacteria locally as well as the entry of other toxins in your bloodstream.

According to scientists, when the internal tampon is too full, vaginal walls might suffer small lesions or it may break small blood vessels that bacteria can use to enter the bloodstream. Take into consideration to use smaller internal tampons and try alternating them with external tampons when the amount of menstruation is low. Schedule yourself for a medical consultation if you are suspicious about a wound infection from a possible surgery.

This syndrome may return. People who once had it can experience it again at a later time. If you`ve experienced this syndrome, don`t use internal tampons.

  • Wash your hands before or after using your tampon in order to prevent any bacteria from spreading.
  • Always make certain you put your tampon properly. Typically, you shouldn`t really feel it. Any discomfort should signal you that something isn`t right.
  • The tampons should be changed every 8 hours. After this period of time, any risk of infection increases.
  • If you enter the water, change your tampon right after exiting so you can prevent irritation.
Image courtesy of wikihow.com

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