Infectious Diseases

Toxic Shock Syndrome - Causes, Symptoms, Diagnosis, Complications, and Treatment

Written by
Dr. Sneha Kannan
and medically reviewed by Dr. Shaiza Hashmi

Published on Jan 11, 2020   -  4 min read

Abstract

Abstract

Toxic shock syndrome (TSS) is a type of life-threatening bacterial infection. Read about its causes, symptoms, diagnosis, complications, and treatment options.

Toxic Shock Syndrome - Causes, Symptoms, Diagnosis, Complications, and Treatment

What Is Toxic Shock Syndrome?

Toxic shock syndrome, otherwise called TSS, is a rare and potentially fatal complication of some types of bacterial infection. This infection usually starts with a strain of staphylococcus or streptococcus bacteria. People of any age and gender can get affected by this condition, but it is more commonly seen in women in the reproductive age group.

In the 1980s, several healthy women died mysteriously due to sudden fever, shock, and multiple organ failure. Only after this, TSS was noted as a health hazard for women in their reproductive age. In the US, TSS affects 6 of 100,000 women every year during the 1980s. But after 1986, due to the removal of super-absorbent tampons from the market, the number went down to 1 in every 100,000.

Complications of skin injury or surgery can result in TSS in men, children, and menopausal women also.

Types of Toxic Shock Syndrome

The types of TSS are:

  1. Staphylococcal TSS - it is caused by the bacteria Staphylococcus aureus.

  2. Streptococcal TSS - it is caused by group A Streptococcus bacteria.

What Are the Signs and Symptoms of Toxic Shock Syndrome?

The signs and symptoms of TSS develop all of a sudden and worsen quickly. The signs of TSS are which appear in a few hours are:

  • High fever.

  • Vomiting.

  • Headaches.

  • Diarrhea.

  • Rashes that look like sunburn on palms and soles.

  • Dizziness.

  • Muscle pain.

  • Eyes, mouth, and throat redness.

  • Loss of consciousness.

  • Confusion.

  • Low blood pressure (hypotension).

  • Seizures.

If left untreated, this condition can progress rapidly and can be fatal in less than 48 hours, as it leads to kidney failure, shock, and multiple organ failure. So if you regularly use tampons or recently underwent surgery or suffered a skin injury or infection, and experience these symptoms, then go to the emergency room immediately. The tampon should be immediately removed.

What Causes Toxic Shock Syndrome?

Infection with Streptococcus or Staphylococcus bacteria can result in toxic shock syndrome. The factors that increase the risk of these infections are:

  1. Using super-absorbent tampons.

  2. Soft-tissue injuries.

  3. Burn injury.

  4. A localized infection like a boil.

  5. Use of a contraceptive sponge.

  6. Infected wounds.

  7. Childbirth.

  8. Viral infections, such as chickenpox and flu.

20 to 30 % of humans carry these bacteria in our skin and nose without any side effects. When people do not have the necessary antibodies to fight off these bacteria, only then they result in infections.

It is believed that super-absorbent tampons, as they are kept inside the body for a prolonged time, becomes the perfect environment for bacteria to grow. The fibers used in these tampons scratch the vaginal walls, which forms the way for bacteria to enter your body.

Similarly, bacteria can enter the bloodstream through cuts, burns, and local infections. The bacteria release toxins in the bloodstream, which spread to other organs. This results in low blood pressure, which leads to shock and symptoms like confusion and loss of consciousness. As these toxins start to spread, they shut down the functioning of various organs in the body, resulting in multiple organ failure.

How Is Toxic Shock Syndrome Diagnosed?

TSS is rare, so the doctor needs to identify the symptoms and treat it promptly, as the disease progresses rapidly and can be fatal. The symptoms to look out for are:

  • Fever more than 39 to 40.5 ℃ or 102.02 ℉.

  • Very low blood pressure.

  • Skin rashes.

  • Results that suggest that a minimum of three organs have been affected.

The following tests might be necessary:

  1. Blood tests and urinalysis - to check organ function or organ failure and to detect the presence of staph or strep infection.

  2. Samples taken from any lesion, nose, vagina, etc., are sent for investigation to check for infection.

  3. CT scan or MRI or chest X-ray - to detect tissue damage.

  4. Lumbar puncture - to check how much the disease has progressed.

How Is Toxic Shock Syndrome Treated?

If you have been diagnosed with toxic shock syndrome, then you will be treated in the hospital. The treatment options include:

  • Antibiotics are given intravenously and the source of infection is identified.

  • Medicines are given to bring the blood pressure back to normal.

  • Fluids are given to prevent dehydration.

  • Symptomatic treatment is given for any other signs or symptoms.

  • If your kidneys are not functioning properly, then dialysis might be needed.

  • Surgery is done to remove dead or necrosed tissue from the site of infection or to drain an abscess.

What Are the Possible Complications of Toxic Shock Syndrome?

TSS can lead to life-threatening complications, as it results in multiple organ failure, shock, and death. This condition has to be promptly treated to prevent complications. The possible complications include:

  1. Liver failure - The symptoms of liver failure include jaundice (yellowing of the skin and eyes), abdominal pain, problems concentrating, nausea, vomiting, confusion, etc.

  2. Heart failure - The symptoms include palpitations, chest pain, cough, wheezing, loss of appetite, poor concentration, tiredness, weakness, and dyspnea.

  3. Kidney failure - Fatigue, nausea and vomiting, hiccups, muscle cramps, itching, chest pain, dyspnea, hypertension, swollen feet and ankles, and urination problems are some of the common symptoms of kidney failure.

  4. Low blood flow through the body (shock).

Preventive Measures:

The following measures can reduce the risk of developing toxic shock syndrome:

  1. Make sure you change your tampon every 4 to 8 hours.

  2. Always use low-absorbency tampons or sanitary pad during periods.

  3. If you use a menstrual cup, then go for a reusable silicone menstrual cup.

  4. Clean your hands properly while changing the menstrual cup.

  5. When the menstrual flow is light, use a sanitary pad instead of a tampon.

  6. Frequently wash your hands thoroughly.

  7. If you underwent any surgery, keep the surgical incisions clean and dry.

  8. Go to your doctor regularly to change the surgical dressing.

  9. Avoid using tampons if you suffered from toxic shock syndrome in the past.

It is crucial to diagnose and treat this condition immediately to prevent permanent organ damage or death. If you feel you are exhibiting symptoms of TSS, then go to the emergency room immediately. For more information on toxic shock syndrome, talk to a doctor online.

Last reviewed at:
11 Jan 2020  -  4 min read

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