Toxic shock syndrome

Toxic shock syndrome (TSS) is a rare but life-threatening bacterial infection caused by Staphylococcus aureus and Streptococcus pyogenes bacteria.

These bacteria normally live harmlessly on the skin, nose or mouth but can invade the body's bloodstream and release poisonous toxins.

The toxins also damage tissue, including skin and organs, and can disturb many vital organ functions.

What to do

TSS is a medical emergency and you should see your GP as soon as possible if you have any of the symptoms of TSS.

If your GP suspects you have TSS, you'll be referred to hospital immediately and may be treated in an intensive care unit. The goal is to fight the infection with antibiotics and support any functions of the body that have been affected.

How is toxic shock syndrome diagnosed?

There is no single test for toxic shock syndrome (TSS). The condition is diagnosed by looking for the typical symptoms and checking for evidence of organ failure.

Organ function can be tested in a variety of ways, including blood and urine tests.

A confident diagnosis of TSS can usually be made when:

you have a temperature of 38.9C (102F) or above
you have low blood pressure, fainting and dizziness
you have a widespread, flat, red skin rash
three or more of your organs have been affected by infection
an infection caused by staphylococcus or streptococcus is apparent or likely

If all of the above are present, it is likely that you have TSS.

Who is at risk?

Anyone can get TSS – men, women and children.

For reasons that are still not understood, a significant proportion of cases occur in women who are on their period and using a tampon, particularly tampons that are designed to be 'super absorbent’.

TSS can also occur as a result of an infected boil, insect bite or wound, for example. Some cases are associated with skin damage from a burn or scald, which allows the bacteria to enter the body and release toxins.

Find out more about the causes of TSS.

The risk of TSS is greater in young people. It is thought that this is because many older people have developed immunity (resistance) to the toxins produced by the bacteria.

Outlook

TSS is a serious, life-threatening condition. If left untreated, the combination of shock and organ damage can result in death – especially if the infection was caused by streptococcus bacteria.

If TSS is diagnosed and treated early with antibiotics, there is a good chance of recovery, and improvement is usually shown within 48 hours. However, TSS associated with streptococcus can be severe and rapidly progess to organ failure.

The condition can also reoccur in those who recover.