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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

There is no one specific test that establishes the diagnosis of TSS. The diagnosis of TSS is difficult until the characteristic symptoms evolve and a source for the infection is identified. Besides a thorough physical examination (which includes a pelvic examination in women), blood tests will usually be ordered and might include a white blood cell count (to look for signs of infection), blood cultures (evaluating for possible bacteria in the bloodstream), and evaluation of kidney and liver function. Blood tests to exclude other diseases may also be ordered.

Chest X-rays or CT scans of the abdomen or pelvis can be ordered to evaluate the internal organs, depending on the results of the initial evaluation.

If you suspect that you have TSS, you should immediately seek medical care or go to an emergency department for evaluation. Foreign material such as tampons, contraceptive devices, or wound packings must be immediately removed. Treatment may involve a combination of the following:

• Intravenous (IV) fluids to stabilize the blood pressure, possibly in combination with medications to raise blood pressure
• IV antibiotics to fight the source of the infection
• Oxygen administration
• Removal of tampons, nasal packings, or other suspected sources of the infection
• Surgical interventions to drain the source of the infection in cases of an abscess and remove necrotic tissue (dead tissues)
• Dialysis if kidney failure develops

Other therapies

• IV immunoglobulin has been reported to be beneficial in severe cases of TSS.
• Neither hyperbaric oxygen therapy (oxygen given at higher than normal amounts and pressures) nor high-dose corticosteroid treatments have shown any beneficial outcomes in patients with TSS.