What is toxic shock syndrome?

Toxic shock syndrome (TSS) is a very rare infection caused by bacteria. It can be very serious.

TSS is not spread from person to person. It can affect males and females.

What are the symptoms of toxic shock syndrome?

If you think you have toxic shock syndrome you should go to your nearest hospital. Or you can call triple zero (000) for an ambulance.

TSS can cause many symptoms, including:

• a sudden high temperature (40°C or above)
• vomiting
• diarrhoea
• dizziness from low blood pressure
• aching muscles
• confusion
• a red rash like sunburn on the hands and feet that later peels

What causes toxic shock syndrome?

TSS is caused by:

• staphylococcus aureus (staph) — most often the cause
• streptococcus pyogenes (strep) — less often the cause

In 1 in 3 people, these bacteria can be normally found:

• on the skin
• in the nose
• in the armpits
• in the groin or vagina

They live here without causing any health problems.

In rare cases, the bacteria produce a toxin, which can cause TSS in some people.

In females, most cases of TSS happen during menstruation (when you are having your period). These cases have been associated with the use of:

• tampons
• menstrual cups
• diaphragms

However, it’s the bacteria and not the tampon that causes TSS.

TSS can happen from an infected:

• cut
• wound from surgery
• vaginal birth or caesarean section
• boil
• burn

In about 1 in 3 cases of TSS no bacterial infection is found.

Your chances of getting TSS are higher if you've had it before.

When should I see my doctor?

Symptoms develop quickly so you need to get urgent treatment.

Early diagnosis and treatment are very important.

How is toxic shock syndrome diagnosed?

Your doctor will ask about your symptoms and general health and examine you.

They will recommend tests, including:

• blood tests
• other tests to help find the bacteria (such as a throat swab)
• a chest x-ray

How is toxic shock syndrome treated?

People with TSS need to be treated in hospital with antibiotics for the infection. You may also need:

• fluids to rehydrate you
• medicine to control your blood pressure
• oxygen

If you are very ill, you may be cared for in the intensive care unit.

Treatment is normally successful if TSS is found early on.

Can toxic shock syndrome be prevented?

There are several ways you can help lower your chance of getting TSS. These include:

• washing your hands regularly, including before and after tending to wounds or burns
• making sure you care for all wounds and burns properly
• looking out for signs of infection, such as a rash, swelling or pain

Period hygiene

When you have your period, you should:

• wash your hands before and after using a tampon
• use a tampon with the right absorbency for your menstrual flow
• change tampons as often as it says on the packet — about every 4 to 8 hours
• change from tampons to sanitary pads every so often during your period
• using a sanitary pad at night
• never use more than one tampon at a time
• remove the last tampon at the end of your period

Complications of toxic shock syndrome?

Your chances of getting TSS are higher if you've had it before.

Resources and support

You can call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with 24 hours a day, 7 days a week.