Toxic Shock Syndrome

Toxic Shock Syndrome

Toxic shock syndrome (TSS) is a serious but uncommon infection caused by either Staphylococcus aureus bacteria or by streptococcus bacteria.


Originally linked to the use of tampons, especially high-absorbency ones and those that are not changed frequently, it's also known to be associated with the contraceptive sponge and diaphragm birth control methods.  In the most common form of toxic shock syndrome, the bacteria live in the vagina of women who are infected, and the bacterial growth is encouraged by the presence of a tampon. However, these toxins can be produced from bacteria in other locations in the body as well.


  • Fewer- greater than 1020 F
  • Headache
  • Muscle aches
  • Sore throat & cough
  • Nausea & Vomiting
  •  Abdominal pain
  • Fainting
  • Diarrhea
  • Low blood pressure.
  • Organ failure (usually kidneys and liver)
  • Redness of eyes, mouth, throat

A woman who is pregnant or has recently given birth has a greater risk for strep TSS, especially if one of her children has strep throat. Any pregnant woman or new mother with a child who shows signs of strep throat should talk to her gynecologist or obstetrician.


Treatment  Options

TSS can progress rapidly and cause life-threatening complications, treatment almost always takes place in a hospital where a person's condition can be closely monitored. Treatment for shock or organ failure is usually needed before any test results are available.

The course of treatment includes:
  • Removal of the source of the infection. If a woman is using a tampon, diaphragm, or contraceptive sponge, it is removed immediately. Infected wounds are usually drained and cleaned to rid the area of bacteria.
  • Treatment of complications of the illness.  The specific treatment depends on what problems have developed. Large amounts of intravenous (IV) fluids are typically used to replace fluids lost from vomiting, diarrhea, and fever and to avoid complications of low blood pressure and shock.
  • Administer of antibiotics  to kill the bacteria that are producing the toxins causing TSS. An antibiotic that stops toxin production is started immediately to treat symptoms.


Menstrual toxic shock syndrome can be prevented by avoiding the use of highly absorbent tampons. You can reduce your risk by changing tampons more frequently and using tampons only once in a while (not regularly) during menstruation.

If you're a woman using tampons:
  • use a tampon with the lowest absorbency suitable for your menstrual blood flow
  • change your tampon frequently - washing your hands before and after you insert it
  • use a sanitary towel or panty liner from time to time during your period
  • never insert more than one tampon at one time
  • use a sanitary towel at night instead of a tampon. If you do use a tampon at night, insert a new tampon before going to bed and remove it as soon as you wake up

Once you have had TSS you can get it again. Women who have had TSS are advised not to wear a tampon or use an internal barrier contraceptive such as a diaphragm or cap. 



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