What is toxic shock syndrome?

Toxic shock syndrome (TSS) is a rare complication that can happen in response to a bacterial infection. It can be serious. It can affect both males and females.

Toxic shock syndrome is triggered by bacteria such as:

• Staphylococcus aureus (staph)
• Streptococcus pyogenes (strep)

These bacteria are normally found:

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

Bacteria often live in and on the body without causing any health problems. Sometimes, they can cause mild infections such as skin infection (cellulitis), sore throat (pharyngitis) or impetigo. In rare cases, the bacteria produce a toxin that triggers an immune response. This response is what leads to toxic shock syndrome.

What are the symptoms of toxic shock syndrome?

If you think you have toxic shock syndrome call triple zero (000) and ask for an ambulance, or go to your nearest emergency department.

Toxic shock syndrome can cause many symptoms, including:

• a sudden high temperature
• vomiting
• diarrhoea
• dizziness from low blood pressure
• aching muscles
• confusion
• a red rash that looks like sunburn on the hands and feet

What causes toxic shock syndrome?

In females, most cases of toxic shock syndrome happen during menstruation (when you are having your period). This is also known as 'menstrual toxic shock syndrome' and is associated with the use of:

• tampons
• menstrual cups
• diaphragms

It's the bacteria — not the tampon itself — that can lead to toxic shock syndrome. Leaving a tampon in for too long can make it easier for the bacteria to grow. That's why it's important to change your tampon regularly and follow instructions on the packaging.

Toxic shock syndrome can also happen from an infected:

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

When should I see my doctor?

Seek urgent medical care if you think you have symptoms of toxic shock syndrome.

Menstrual toxic shock syndrome is more likely to happen in females 13 to 24 years old.

Non-menstrual toxic shock syndrome is more likely to happen in adults 50 to 69 years old who have other conditions such as:

• diabetes
• kidney disease
• heart problems
• liver disease

Early diagnosis and treatment are important — see your doctor when you first notice symptoms.

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 and swabs of areas that may be affected by bacteria. This can include throat or vaginal swabs.

How is toxic shock syndrome treated?

People with toxic shock syndrome need treatment in hospital with antibiotics for the underlying infection. You may also need:

• fluids via a drip in your arm
• medicine to control your blood pressure
• oxygen via a mask or small tube in your nose

If you are very ill, you may need care in an intensive care unit.

If you have parts of your body that are severely infected, you may need surgery.

What are the complications of toxic shock syndrome?

If not diagnosed and treated quickly, toxic shock syndrome can lead to complications such as:

• infection of the blood (bacteraemia)
• kidney issues
• severe breathing difficulty

In the long term, toxic shock syndrome can cause kidney, liver and heart issues. This depends on the type of bacteria that caused toxic shock syndrome, and how severe the symptoms were.

Can toxic shock syndrome be prevented?

There are several ways you can help lower your chance of getting bacterial infections that can lead to toxic shock syndrome. These include:

• washing your hands regularly
• 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
• change tampons as often as it says on the packet — about every 4 to 8 hours
• switch from tampons to sanitary pads every so often during your period
• use a sanitary pad at night
• never use more than one tampon at a time
• remove the last tampon at the end of your period

Resources and support

Call healthdirect on 1800 022 222 at any time to speak to a registered nurse (known as NURSE-ON-CALL in Victoria) for more information and advice.

Jean Hailes has information available on different types of period products you can use and how often to change them.

Languages other than English

The Royal Children's Hospital has information on fever in children available in many community languages.

NSW Health has posters on hand hygiene available in several community languages.

Information for Aboriginal and/or Torres Strait Islander peoples

Watch the No Germs on Me video on hand washing.

Find an Aboriginal Community Controlled Health Organisation (ACCHO) or Affiliate near you.