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Toxic shock syndrome

Published by Bupa's health information team, March 2008.

This factsheet is for people who have toxic shock syndrome, or who would like more information about it.

Toxic shock syndrome is a rare but serious type of blood poisoning caused by toxin-producing Staphloccocus and Streptococcus bacteria. It affects about 40 people each year in the UK. It can affect men, women and children of any age.

About toxic shock syndrome
Symptoms
Complications
Causes
Diagnosis
Treatment
Prevention
Further Information
Questions and answers
Related topics
Sources

About toxic shock syndrome

Toxic shock syndrome (TSS) is caused by toxins released by bacteria belonging to the Staphloccocus and Streptococcus family.

Bacteria belonging to the Staphloccocus family such as S. aureus are common. It's estimated that one in three healthy people carry it on their skin, in their nose or in the back of their throat. Bacteria belonging to the Streptococcus family are usually found on the skin, in the mouth, in the the back of the throat and in the intestines.

TSS is often associated with tampon use in women but it can affect men, women and children of any age.

Symptoms

The symptoms of TSS tend to come on suddenly and include:

a high temperature
vomiting
diarrhoea
red rash (rather like sunburn) which may peel, particularly on the hands and feet
excessive tiredness
aching muscles
confusion
feeling light-headed or dizzy

If you develop these symptoms you should contact your GP or the hospital immediately. If you are a woman wearing a tampon you should remove it without delay.

Complications

TSS is a life-threatening condition and requires urgent medical attention. It can cause your blood pressure to drop and your body can go into "shock". This can damage your kidneys, liver and lungs.

Causes

Toxic shock syndrome (TSS) is caused by toxins released by bacteria belonging to the Staphloccocus and Streptococcus family. These are normal bacteria found on the skin and in the body and are not harmful to healthy people. However, if your body is under particular stress, or if you have suffered trauma or ill health, these bacteria can get into the blood stream and cause problems. For example TSS can develop after:

an injury
suffering burns
an infection such as chicken pox or influenza (flu)
having surgery

Women are most at risk of getting TSS:

during menstruation - particularly if you are using tampons
after childbirth
when using an internal barrier contraceptive (such as a diaphragm)

Diagnosis

Your doctor will ask about your symptoms, examine you and take your blood pressure. He or she may also ask you about your medical history.

It's important that you tell your doctor if you have been wearing a tampon, had a recent injury (such as an accident or burn) or an operation. This can help your doctor identify how you got the infection.

TSS is usually diagnosed from your symptoms. Your doctor will usually take blood samples to identify which bacteria you are infected with.

Treatment

TSS is a serious and potentially life-threatening condition. You will need to go to hospital for treatment.

Your doctor will need to examine and clean any possible sites of infection such as surgical wounds or burns. If you are wearing a tampon or an internal contraceptive device it will be removed immediately.

You will be given antibiotics to treat the infection and possibly fluids through a drip to keep you hydrated.

You will be closely monitored and given intensive support if any organs are affected, for example, ventilation (if your lungs are affected) or kidney dialysis.

You may also need to have an injection of immunoglobulin (a protein that helps fight infection) but this isn't a routine treatment.

Prevention

There is no clear way to prevent the infection. The key advice is to look out for the signs and symptoms and seek immediate medical attention if you think you have TSS.

The link between TSS and tampon use is unclear but tampon absorbency (the amount of menstrual blood a tampon absorbs) is thought to be a factor.

If you are a woman using tampons, you are advised to:

use a tampon with the lowest absorbency (suitable to 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 but if you are using 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.

Further information

The Toxic Shock Syndrome Information Service
020 7617 8040
www.toxicshock.com