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Toxic shock syndrome (TSS) is a severe and potentially fatal condition triggered by toxins produced by certain bacteria, most commonly Staphylococcus aureus (staph) and occasionally by group A streptococcus (strep). Although it is often linked to tampon use during menstruation, TSS can affect anyone, regardless of age or gender. Risk factors include not only menstruation-related products like tampons and menstrual cups, but also skin wounds, surgical sites, and any other type of skin injury that provides a breeding ground for bacteria.
The symptoms of toxic shock syndrome develop suddenly and can escalate quickly, affecting vital organs such as the heart, liver, and kidneys. Despite its severity, timely diagnosis and treatment can lead to recovery in most cases. It’s critical for individuals with signs of TSS, especially if they have recently used tampons, experienced a skin injury, or had surgery, to seek medical attention immediately to mitigate risks and improve outcomes.
Symptoms
Toxic shock syndrome typically starts suddenly, with symptoms appearing within a few days after bacteria enter the bloodstream. The symptoms is determined by the type of bacteria causing the toxins.
Common symptoms include:
- Chills, aches throughout the body, and other flu-like symptoms that occur suddenly.
- A sunburn-like rash, especially on the palms and soles
- Low blood pressure
- Vomiting and nausea
- Watery diarrhea
- Conjunctivitis, or redness in the throat and eyes
- Confusion
- Seizures
- Headaches
- Feeling lightheaded, faint, or dizzy
If any of the symptoms occur, especially if one have recently had surgery, a skin wound, or used tampons, seek immediate medical attention.
Causes
Toxic shock syndrome (TSS) is primarily caused by toxins produced by the bacteria Staphylococcus aureus (staph) and Streptococcus pyogenes (group A strep), although less commonly, it can also be caused by Clostridium sordellii. Typically, these bacteria innocuously inhabit the skin or mucous membranes like the throat or mouth, but under specific conditions, some strains can proliferate rapidly and release toxins. Factors such as the use of super-absorbent tampons during a light menstrual flow or infrequent changing of tampons can facilitate bacterial growth and toxin production. Additionally, tampons can create small lacerations in the vagina, providing a pathway for bacteria to enter the bloodstream.
Apart from tampon use, TSS risks are associated with any object left in the vagina longer than recommended, including contraceptive devices like cervical caps, sponges, diaphragms, or menstrual cups. Moreover, TSS can develop from bacteria entering the body through cuts, wounds, or following medical procedures such as surgery, childbirth, or even after treating a nosebleed with packed gauze. This highlights the importance of timely medical attention and proper hygiene practices to prevent such infections.
Risk factors
Anyone is susceptible to toxic shock syndrome. People of all ages can get streptococcal toxic shock syndrome, and about half of staphylococcal TSS cases occur in menstruating women.
The risk of TSS increases with:
- Using contraceptive sponges, diaphragms, superabsorbent tampons, or menstrual cups
- Being afflicted with a virus, such the chickenpox or the flu
- Having skin burns or wounds
- Having just undergone surgery
Diagnosis
Initial testing:
- Blood or urine tests: These are conducted to identify the type of bacteria or virus causing the infection.
- Physical examinations: An examination of the vagina may be performed.
- Tissue cultures: Cultures may be taken from the vagina, cervix, or throat to detect the presence of Staphylococcus or Streptococcus bacteria.
For non-menstrual toxic shock syndrome:
- Tissue sampling: Tissue from the site of the wound or infection is collected for analysis.
Advanced testing (for severe or progressive symptoms):
- Computed tomography(CT) scan: A scan to provide detailed images of the body’s structures.
- Chest x-ray: An x-ray to examine the condition of the chest and lungs.
- Spinal tap (lumbar puncture): A procedure to collect cerebrospinal fluid for testing.
Treatment
If you develop toxic shock then hospitalization is typically required. During your stay, the following treatments will be administered:
- Antibiotics: You’ll receive antibiotics while doctors investigate the source of the infection.
- Medication and fluids: Medications will be given to stabilize low blood pressure, along with fluids to address dehydration.
- Supportive care: Additional supportive care will be provided to manage other signs and symptoms.
- Dialysis: If kidney failure occurs due to the toxins produced by staph or strep bacteria and accompanying low blood pressure, dialysis may be necessary.
- Surgery: Surgery might be needed to remove dead tissue from the infection site or to drain the infection.
