Toxic Shock Syndrome: Symptoms, Diagnosis and Treatment

Teen woman with stomach acheToxic shock syndrome, also known as TSS, is a potentially life-threatening condition caused by toxins. These toxins are produced by certain types of infectious bacteria, and the condition is most commonly linked to the use of tampons in menstruating women. Although it is most commonly linked to the use of tampons, it can also occur in anyone of any age or gender. Around half of toxic shock syndrome cases are linked to the use of tampons, but the remaining half of cases are caused by other situations.

In the U.S., estimated incidences of toxic shock syndrome is around 1/100,000 women of between 15-44 years of age, although actual cases may stand at twice that. Risk factors for toxic shock syndrome include the use of tampons, especially tampons that are left in place for an extended period of time, barrier contraceptive devices, surgery, especially nasal surgery, wound packing after surgery such as nasal packing and post-operative infections of wounds.

What are the Symptoms of Toxic Shock Syndrome?

The symptoms of toxic shock syndrome are severe, but some of them can mimic other medical problems, such as flu or food poisoning – so the syndrome may go undiagnosed until it is in the latter stages. Unfortunately, 5% of toxic shock syndrome sufferers will die from multi-organ failure. Signs and symptoms to look out for include:

  • Flu-like symptoms, such as headache, cold and fever
  • Rapid onset of a number of symptoms, including nausea, vomiting, fever, diarrhea, very low blood pressure, fainting and dizziness and a widespread skin rash
  • As the blood pressure gets lower, dizziness and confusion become apparent and other symptoms could appear, including peeling of the hands and feet
  • Seizures and fits could also occur in a small percentage of cases
  • Multi-organ failure can lead to pain, discomfort and bleeding

How is Toxic Shock Syndrome Diagnosed?

There is no one specific test for toxic shock syndrome that can establish a diagnosis. The tests given will depend on the symptoms, and if the characteristic symptoms have not yet developed, tests may not be carried out. A thorough physical examination will be performed, including a pelvic exam for women. Blood tests will usually be ordered as blood samples can usually indicate signs of infection, particularly if a white blood count is ordered. Cultures will be evaluated for possible signs of bacteria which could point to infection and blood tests may be performed to exclude other diseases before a diagnosis of toxic shock syndrome is given. Chest X-rays may also be performed to scan the internal organs, depending on the results of the initial evaluation.

Treatment for Toxic Shock Syndrome

If you suspect that you have toxic shock syndrome, you should seek immediate medical care or advice. Foreign material, such as tampons, wound packing or contraceptive devices should be removed immediately, as soon as you start to notice symptoms.

Treatment for toxic shock syndrome is likely to include a combination of the following:

  • IV fluids to stabilize blood pressure, given intravenously as they will be delivered to where they are needed more quickly than if they were given orally
  • IV antibiotics to fight off the infection
  • Removal of all suspected sources of infection
  • Oxygen administration if the patient has difficulty in breathing
  • Surgery to drain the source of infection if an abscess or dead tissue occurs
  • Dialysis if kidney failure occurs as a result of the infection
  • IV immunoglobulin in severe cases of toxic shock syndrome

Reduce your risk of toxic shock syndrome by changing your tampon every four hours. Don’t wear tampons to bed, and if you are particularly worried, don’t use them at all –  use pads instead. For more information, speak to your doctor.