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Medical Author:

Jerry R. Balentine, DO, FACEP

Jerry R. Balentine, DO, FACEP

Dr. Balentine received his undergraduate degree from McDaniel College in Westminster, Maryland. He attended medical school at the Philadelphia College of Osteopathic Medicine graduating in1983. He completed his internship at St. Joseph's Hospital in Philadelphia and his Emergency Medicine residency at Lincoln Medical and Mental Health Center in the Bronx, where he served as chief resident.

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Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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In this Article

• Toxic shock syndrome (TSS) facts
• What is toxic shock syndrome (TSS)?
• What causes toxic shock syndrome?
• What are the risk factors for toxic shock syndrome?
• What are toxic shock syndrome symptoms and signs?
• How is toxic shock syndrome diagnosed?
• What is the treatment for toxic shock syndrome?
• How is toxic shock syndrome prevented?
• Toxic Shock Syndrome Index

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 (diaphragm or sponge), surgery (especially nasal surgery), the use of wound packings (such as nasal packings), and postoperative wound infection.

Patients may experience a few days of mild flu-like symptoms before the TSS develops, but TSS itself is characterized by the rapid onset of specific symptoms, including high fever, nausea, vomiting, diarrhea, low blood pressure, and widespread skin rash. This will usually progress to a worsening of low blood pressure, dizziness, confusion, peeling of the skin of the palms and soles of the feet (which develops after one to two weeks of rash), headaches, and occasionally seizures. Ultimately, multiorgan failure may develop, and this leads to death in approximately 5% of all those affected.