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Toxic shock syndrome

Staphylococcal toxic shock syndrome; Toxic shock-like syndrome; TSLS

Toxic shock syndrome is a serious disease that involves fever, shock, and problems with several body organs.

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Normal uterine anatomy (cut section)
Bacteria

Causes

Toxic shock syndrome is caused by a toxin produced by some types of staphylococcus bacteria. A similar problem, called toxic shock-like syndrome (TSLS), can be caused by toxin from streptococcal bacteria. Not all staph or strep infections cause toxic shock syndrome.

The earliest cases of toxic shock syndrome involved women who used tampons during their menstrual periods. However, today less than one half of cases are linked to tampon use. Toxic shock syndrome can also occur with skin infections, burns, and after surgery. The condition can also affect children, postmenopausal women, and men.

Risk factors include:

Symptoms

Symptoms include:

Exams and Tests

No single test can diagnose toxic shock syndrome.

The health care provider will look for the following factors:

In some cases, blood cultures may be positive for growth of S aureus or Streptoccus pyogenes.

Treatment

Treatment includes:

The goal of treatment is to maintain important body functions. This may include:

Outlook (Prognosis)

Toxic shock syndrome may be deadly in up to 50% of cases. The condition may return in those who survive.

Possible Complications

Complications may include:

When to Contact a Medical Professional

Toxic shock syndrome is a medical emergency. Seek medical help right away if you develop a rash, fever, and feel ill, particularly during menstruation and tampon use or if you have had recent surgery.

Prevention

You can lower your risk for menstrual toxic shock syndrome by:

Related Information

Acute kidney failure
Heart failure
Shock

References

Gardella C, Eckert LO, Lentz GM. Genital tract infections: vulva, vagina, cervix, toxic shock syndrome, endometritis, and salpingitis. In: Lobo RA, Gershenson DM, Lentz GM, Valea FA, eds. Comprehensive Gynecology. 7th ed. Philadelphia, PA: Elsevier; 2017:chap 23.

Kroshinsky D. Macular, papular, purpuric, vesiculobullous, and pustular diseases. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 410.

Larioza J, Brown RB. Toxic shock syndrome. In: Kellerman RD, Rakel DP, eds. Conn's Current Therapy 2020. Philadelphia, PA: Elsevier 2020:649-652.

Que Y-A, Moreillon P. Staphyloccus aureus (including staphyloccocal toxic shock syndrome). In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 194.

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Review Date: 6/15/2020  

Reviewed By: Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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