Toxic Shock Syndrome Fact Sheet
What is toxic shock syndrome?
Toxic shock syndrome (TSS) is a serious illness that affects multiple systems of the body and is
caused by toxins released by certain bacteria. Staphylococcus aureus (commonly referred to as
“staph”) and Streptococcus pyogenes (usually referred to as group A Streptococcus or “strep”) are
the two bacteria most often associated with toxic shock syndrome, although in rare cases other
bacteria can cause the same symptoms.
Who gets TSS?
TSS is rare. Recognized groups at risk of S. aureus TSS include menstruating women using tampons,
menstrual cups, or other inserted devices, women using diaphragms or contraceptive sponges, and
anyone with a S. aureus infection of another body site. The risk is much lower now than it was in the
past because tampon manufacturers have made changes so their products are safer. Streptococcal
TSS is more likely to occur in the young, elderly, and persons with underlying conditions that
weaken the immune system.
How is TSS spread?
TSS is a complication of infection and cannot be spread to others. However, the bacteria that cause
the infections that can lead to TSS, S. aureus and Streptococcus, can be spread from person-to-
person through direct contact.
What are the symptoms of TSS?
Common signs and symptoms include fever, muscle aches, vomiting and diarrhea, and a sunburn-
like rash that later peels. Hypotension (low blood pressure), shock, multi-organ failure, and death
can occur.
How soon after exposure do symptoms appear?
TSS can develop within 12 hours in some cases.
How is TSS diagnosed?
TSS is usually diagnosed by a physician based on an assessment of the patient’s signs, symptoms,
and laboratory results.
What is the treatment for TSS?
Treatment includes antibiotics and supportive care (measures to help improve the symptoms of the
disease). This may include intravenous (IV) fluids, medications to raise blood pressure, equipment to
aid breathing, dialysis and other measures to counteract the effects of the toxins.
How can TSS be prevented?
Some TSS can be prevented by using the lowest absorbency tampon needed, changing tampons per
the manufacturer’s directions, thoroughly washing menstrual cups, and by switching between
