Toxic Shock Syndrome (TSS)
Medical Author: Jerry Balentine, DO, FACEP
Medical Editor: Melissa Conrad Stöppler, MD, and William C. Shiel Jr., MD, FACP, FACR
What causes toxic shock syndrome?
Toxic shock syndrome (TSS) is a life-threatening condition caused by toxins
produced by certain types of infecting bacteria. The condition has been most
often associated with the use of tampons in menstruating women. In 1980, an
outbreak of TSS was linked to the use of one brand of superabsorbent tampons.
Although this outbreak was linked to toxins produced by the Staphylococcus
aureus bacteria, TSS can also be caused by toxins from the group A Streptococcus
bacteria. The condition is sometimes subdivided and referred to as staphylococcal TSS and streptococcal TSS.
Although this disease has been frequently linked to the use of tampons in
menstruating women, it can affect people of any gender and any age. About half
of the reported cases have been linked to the use of tampons in menstruating
women, while the remaining cases are due to other situations. Tampons,
especially when left in place for a long period of time, are thought to provide
a breeding ground for the bacteria that subsequently release toxins to cause TSS.
When not linked to tampon use, TSS can occur as a complication of surgery or
skin infections.
What are the risk factors for toxic shock syndrome?
In the U.S., the incidence is approximately 1/100,000 women 15-44 years of age,
with the overall incidence estimated at about twice that number.
Risk factors are the use of tampons (especially when left in place for an
extended time period) and barrier contraceptive devices in women, surgery
(especially nasal surgery), the use of wound packings (such as nasal packings),
and postoperative wound infection.
Next: What are the signs and symptoms of toxic shock syndrome? »
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