Toxic Shock Syndrome (TSS)

  • Medical Author:
    Charles Patrick Davis, MD, PhD

    Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

  • Medical Editor: Melissa Conrad Stöppler, MD
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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What are toxic shock syndrome symptoms and signs?

TSS symptoms and signs a resemble those found in other infections; however, the most common symptoms of TSS are as follows:

  • Fever higher than 38.9 C (102 F)
  • Low blood pressure (about <90 systolic)
  • Decreased kidney function
  • Disturbances in blood clotting (platelets less than or equal to 100,000/mm3)
  • Liver involvement (twice the upper limit of normal for liver enzyme measurements)
  • Acute respiratory distress
  • Vomiting
  • A red rash that's flat and/or shedding of the skin
  • Damage and death of soft tissues, such as necrotizing fasciitis, myositis, or gangrene
  • Fatigue
  • Headache

Skin shedding may occur on the palms and soles of the feet about one or two weeks after the initial infection begins.

Picture of skin loss in toxic shock syndrome (TSS)
Picture of skin loss in toxic shock syndrome (TSS); SOURCE: CDC

Some clinicians classify TSS by stages -- others do not. However, early symptoms such as a high fever and a falling blood pressure may occur before later stages of organ damage appear. Early symptoms can be confused with those of other diseases, like norovirus or other viral and bacterial infections, especially in young women.

Medically Reviewed by a Doctor on 3/16/2016
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