Toxic Shock Syndrome (TSS) | Johns Hopkins Medicine

What are the symptoms of toxic shock syndrome? · Nausea and/or vomiting · Lethargy · Flu-like symptoms · Abdominal tenderness · Generalized swelling from fluid ... SkipNavigation ImportantUpdates:COVID-19vaccinations|RecallonPhilipsRespironicsmedicaldevices COVID-19:Wearevaccinatingpatientsages12+.Learnmore: Vaccines,Boosters&AdditionalDoses|Testing|PatientCare|VisitorGuidelines|Coronavirus|Self-Checker|EmailAlerts   PhilipsRespironicsissuedarecallforsomeCPAPandBiLevelPAPdevicesandmechanicalventilators.Learnmore. HealthHome ConditionsandDiseases ToxicShockSyndrome(TSS) ShareonFacebook ShareonTwitter ShareonLinkedin ShareonPinterest ShareviaEmail PrintthisPage Whatistoxicshocksyndrome? Toxicshocksyndrome(TSS)isaclusterofsymptomsthatinvolvesmanysystemsofthebody.Certainbacterialinfectionsreleasetoxinsintothebloodstream,whichthenspreadsthetoxinstobodyorgans.Thiscancauseseveredamageandillness. Whatcausestoxicshocksyndrome? ThefollowingbacteriacommonlycauseTSS: Staphylococcusaureus Streptococcuspyogenes Clostridiumsordellii TSSfromStaphylococcusinfectionswasidentifiedinthelate1970sandearly1980swhenhighlyabsorbenttamponswerewidelyusedbymenstruatingwomen.Duetochangesinhowtamponsaremade,theincidenceoftampon-inducedTSShasdeclined. TSSfromstreptococcusinfectionsismostcommonlyseeninchildrenandtheelderly.Otherpeopleatriskincludethosewithdiabetes,weakimmunesystem,chroniclungdisease,orheartdisease. Staphylococcusinfections.Staphylococcusaureus(orS.aureus)maynormallyexistonaperson'sbodyanddoesnotcauseinfection.Becauseit'spartofthebody'snormalbacteria,mostpeopledevelopantibodiestopreventinfection.S.aureuscanbespreadbydirectcontactwithinfectedpersons.PeoplewhodevelopTSSusuallyhavenotdevelopedantibodiesagainstS.aureus.Therefore,it'snotusuallyconsideredacontagiousinfection.S.aureusinfectionsmayalsodevelopfromanotherinfection,suchaspneumonia,sinusitis,osteomyelitis(infectioninthebone),orskinwounds,suchasaburnorsurgicalsite.Ifanyoftheseareasareinfected,thebacteriacanpenetrateintothebloodstream. Streptococcusinfections.Streptococcuspyogenes(orS.pyogenes)TSSmayoccurasasecondaryinfection.Mostcommonly,thisisseeninpeoplewhohaverecentlyhadchickenpox,bacterialcellulitis(infectionoftheskinandunderlyingtissue),orwhohaveweakimmunesystems. Clostridiumsordelliiinfections.Clostridiumsordellii(orC.sordellii)normallyexistsinthevaginaanddoesnotcauseinfection.Thebacteriamayentertheuterusduringnormalmenstruation,childbirth,orgynecologicalproceduressuchasabortion.IntravenousdrugusecanalsocauseC.sordelliiinfections. Whoisatriskfortoxicshocksyndrome? Thefollowingareriskfactorsfortoxicsyndrome: Historyofusingsuper-absorbenttampons Surgicalwounds Alocalinfectionintheskinordeeptissue Historyofusingthediaphragmorcontraceptivesponge Historyofrecentchildbirth,miscarriage,orabortion Whatarethesymptomsoftoxicshocksyndrome? SymptomsofTSSinvolvemanysystemsandmaylooklikeotherinfections.Whileeachpersonmayexperiencesymptomsdifferently,thefollowingarethemostcommonsymptomsofstaphylococcalTSS: Feverhigherthan102°F(38.9°C) Chills Feelingunwell Headache Fatigue Rashthatisredandflatandthatcoversmostoftheareasofthebody Sheddingoftheskininlargesheets,especiallyoverthepalmsandsoles,seenonetotwoweeksaftertheonsetofsymptoms. Lowbloodpressure Vomiting Diarrhea Musclepain Increasedbloodflowtothemouth,eyes,andvagina,makingthemappearred Decreasedurineoutputandsedimentinurine Decreasedliverfunction Bruisingduetolowbloodplateletcount Disorientationandconfusion ThefollowingarethemostcommonsymptomsofstreptococcalTSS: Dangerouslylowbloodpressure Shock Decreasedkidneyfunction Bleedingproblems Bruisingduetolowbloodplateletcount Rashthatisredandflatandthatcoversmostoftheareasofthebody Liverimpairment Sheddingoftheskininlargesheets,especiallyoverthepalmsandsoles(thisdoesnotalwaysoccur) Difficultybreathing ThefollowingarethemostcommonsymptomsofC.sordelliiTSS: Nauseaand/orvomiting Lethargy Flu-likesymptoms Abdominaltenderness Generalizedswellingfromfluidbuildup Highwhitebloodcellandredbloodcellcount Nofever Lowbloodpressure Veryfastheartrate Howistoxicshocksyndromediagnosed? Rulingoutsimilarillnesses(suchasRockyMountainspottedfever,amongothers)iscriticalindiagnosingTSS.Otherdiagnostictestsmayinclude: Bloodcultures.Testsusedtofindandidentifymicroorganisms. Bloodtests.Teststomeasurebloodclottingandbleedingtimes,cellcounts,electrolytes,andliverfunction,amongothers. Urinetests. Lumbarpuncture.Aprocedureinvolvingtheinsertionofaneedleinbetweenthevertebraeofthespinetodrawspinalfluidandcheckforbacteria. Howistoxicshocksyndrometreated? Specifictreatmentwillbedeterminedbyyourhealthcareproviderbasedon: Yourage,health,andmedicalhistory Extentofthedisease Yourtoleranceforspecificmedications,procedures,ortherapies Expectationsforthecourseofthedisease Youropinionorpreference TreatmentforTSSmayinclude: Givingintravenous(throughavein)antibiotics Givingintravenousfluidtotreatshockandpreventorgandamage Heartmedicationsinpeoplewithverylowbloodpressure Dialysismayberequiredinpeoplewhodevelopkidneyfailure Givingbloodproducts Supplementaloxygenormechanicalventilationtoassistwithbreathing Deepsurgicalcleaningofaninfectedwound Whatarethecomplicationsoftoxicshocksyndrome? TSScanresultinamputationsoffingers,toes,orlimbs,orevendeath. Cantoxicshocksyndromebeprevented? Sincereinfectioniscommon,menstruatinggirlsandwomenshouldavoidusingtamponsiftheyhavehadTSS. PromptandthoroughwoundcareiscrucialinavoidingTSS. Minimalusageofvaginalforeignbodyitems,suchasdiaphragms,tampons,andspongescanalsohelppreventTSS. WhenshouldIcallmyhealthcareprovider? TSSmaystartlikeotherinfections,butitcanquicklyprogresstoaseriouslylife-threateningdisease.Ifamildillnessquicklybecomesseverewithwhole-bodysymptoms,seekimmediatemedicalattention. KeyPointsaboutToxicShockSyndrome Toxicshocksyndromedescribesaclusterofsymptomsthatinvolvemanysystemsofthebody. ItcanbecausedbyStaphylococcusaureus,Streptococcuspyogenes,orClostridiumsordellii. Earlysymptomsaresimilartootherinfectionsbutcanprogressquicklytobecomelife-threatening. TSScanbelife-threateningandrequiresimmediatemedicalattention. NextSteps Tipstohelpyougetthemostfromavisittoyourhealthcareprovider: Beforeyourvisit,writedownquestionsyouwantanswered. Bringsomeonewithyoutohelpyouaskquestionsandrememberwhatyourprovidertellsyou. Atthevisit,writedownthenamesofnewmedicines,treatments,ortests,andanynewinstructionsyourprovidergivesyou. Ifyouhaveafollow-upappointment,writedownthedate,time,andpurposeforthatvisit. Knowhowyoucancontactyourproviderifyouhavequestions. 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