Toxic shock syndrome

**Toxic shock syndrome** or **TSS** is a non-common, deadly infection caused by toxins from bacteria.

Toxic shock syndrome is usually caused by _Staphylococcus_ bacteria, but it can also be caused by _Streptococcus_ bacteria.

## Symptoms

Symptoms of toxic shock syndrome can show up suddenly. The disease can be very deadly. The symptoms are different when it is caused by different bacteria. When it is caused by _Staphylococcus aureus_, the symptoms are generally high fever, low blood pressure, confusion, and malaise. If the disease is not treated, someone with toxic shock syndrome caused by _Staphylococcus aureus_ can go into a coma.

When toxic shock syndrome is caused by _Streptococcus pyogenes_, it usually is a rash that was already there getting worse. People with toxic shock syndrome caused by _Streptococcus pyogenes_ have pain where the rash is, then the following symptoms happen very quickly:

The symptoms of toxic shock syndrome include:

- A high fever that starts quickly
- Low blood pressure
- Vomiting or diarrhea
- A rash that looks like a sunburn, mostly on the palms of the hand and soles of the feet
- Confusion
- Muscle pain
- Redness of the eyes, mouth, and throat
- Seizures
- Headaches

## Causes

Toxic shock syndrome can be caused by many things. The most common reasons are injuries to the skin that allow bacteria to get into the bloodstream, and tampons.

## Treatment

Many people with toxic shock syndrome have to stay in the hospital. If it is very bad, they might have to go to the intensive care unit. If the reason that they have toxic shock syndrome is because of tampon use, doctors will make sure that they take the tampon out. If the reason that they have toxic shock syndrome is an injury (an abscess or other infection), the injury has to be drained.

Antibiotics like cephalosporin, penicillin, and vancomycin are used to stop the bacteria from growing. Clindamycin and gentamicin stop the toxins from being produced.

## Tampons and toxic shock syndrome

In 1978, Procter and Gamble (a United States company that sells many different products) started selling tampons called Rely. Rely tampons could be left in for a whole menstrual cycle, which is from 2 to 8 days. Women who used Rely tampons sometimes got toxic shock syndrome because of this. Other tampons that are left in for a long time can also cause toxic shock syndrome.

## Infobox (medical condition (new))

- **name**: Toxic shock syndrome
- **image**: PDB 1aw7 EBI.jpg
- **caption**: Toxic shock syndrome toxin-1 protein from staphylococcus
- **field**: Infectious disease (medical specialty), Infectious disease
- **symptoms**: Fever, rash, skin peeling, low blood pressure
- **complications**: Shock, kidney failure
- **onset**: Rapid
- **types**: Staphylococcal (menstrual and nonmenstrual), streptococcal
- **causes**: _Streptococcus pyogenes_, _Staphylococcus aureus_, others
- **risks**: Very absorbent tampons, skin lesions in young children
- **diagnosis**: Based on symptoms
- **differential**: Septic shock, Kawasaki's disease, Stevens–Johnson syndrome, scarlet fever
- **treatment**: Antibiotics, incision and drainage of any abscesses, intravenous immunoglobulin
- **prognosis**: Risk of death: ~50% (streptococcal), ~5% (staphylococcal)
- **frequency**: Staphylococcal: 0.3 to 0.5 cases per 100,000 population

Streptococcal: 2 to 4 cases per 100,000 population