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Infections of the Female Reproductive System: Toxic Shock Syndrome

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Toxic shock syndrome (TSS) is a rare, life-threatening complication of bacterial infection according to the Mayo Clinic. The Presbyterian/St. Luke's Medical Center (PSLMC) in Denver says that TSS refers to a combination of symptoms resulting from toxins produced by an infection with either staphylococcus aureus or group A streptococcus pyogenes bacteria.

There are two types of TSS: menstrual (associated with menstruation and tampon use) and non-menstrual.

Regarding the menstrual type, the Mayo Clinic says researchers don't know exactly how tampons may cause TSS. Some believe when super-absorbent tampons are left in place for a long time, they become a breeding ground for bacteria.

Others suggest the tampon’s super-absorbent fibers can scratch the vaginal surface, making it possible for bacteria or their toxins to enter the bloodstream.

The National Institutes of Health (NIH) says the non-menstrual type can occur with skin infections, burns and after surgery. It can affect children, postmenopausal women and men.

McKinley Health Center at the University of Illinois adds that non-menstrual TSS risk is increased for women who use vaginal barrier contraceptive methods like the sponge or diaphragm.

Signs and symptoms of toxic shock syndrome develop suddenly. These include a high fever, low blood pressure, vomiting, diarrhea, chills, nausea, abdominal pain, sore throat, headache, redness of eyes, mouth and throat, confusion, seizures, agitation, sleepiness, joint or muscle pain, vaginal discharge (may be watery or bloody), and swelling in the face and eyelids.

NIH says there can be a widespread, sunburn-like rash with skin peeling one or two weeks after the rash, particularly on the hands and feet.

PSLMC says the initial symptoms may improve, but the disease can progress and cause multiple organ failure. Symptoms of severe TSS include kidney failure, seriously low blood pressure, difficulty breathing, seizures, gangrene, pancreatitis, low platelet count, heart problems, fluid retention and liver failure.

NIH warns that toxic shock syndrome is a medical emergency and may be deadly in up to 50 percent of cases. McKinley Health Center says if TSS is suspected, a patient can be hospitalized in order administer intravenous fluids and antibiotics.

TSS can be prevented. The Mayo Clinic advises changing tampons frequently and alternating between tampons and sanitary napkins whenever possible.

NIH recommends women avoid using highly absorbent tampons. And PSLMC adds it’s wise to store tampons in a clean, dry place and always wash hands with soap and water before and after inserting or removing a tampon.

People who have had toxic shock syndrome are at risk of contracting it again. The Mayo Clinic warns that those people should not use tampons at all.


Infections: Toxic Shock Syndrome. Kids Health from the Nemours Foundation. Web 22 Sept 2011.

Toxic Shock Syndrome. PSLMC.com from HCA-HealthONE LLC. Web 22, Sept 2011.

Toxic Shock Syndrome. PubMed Health by National Center for Biotechnology Information and U.S. National Library of Medicine. Web 22 Sept 2011.

Toxic Shock Syndrome and Tampons. Mckinley.illinois.edu from The Board of Trustees of the University of Illinois. Web 22 Sept 2011.

Toxic Shock Syndrome. MayoClinic.com by Mayo Foundation for Medical Education and Research. Web 22 Sept 2011.

Reviewed September 23, 2011
by Michele Blacksberg RN
Edited by Jody Smith

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We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.

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