Toxic shock syndrome, or TSS, is a rare, acute, life-threatening bacterial illness marked by high fever, lower blood pressure, rash and the shut-down of multiple organ systems caused by Staphylococcus aureus and Streptococcus pyogenes. It occurs as a result of capillary leak and tissue damage due to release of inflammatory cytokines induced by streptococcal toxins.TSS occurs among all age groups. There are an estimated 3.5 cases of streptococcal TSS per 100,000 persons, with a case-fatality rate of 30-60%.
Patients suspected of having TSS should be treated immediately. Tampons, diaphragms, and other foreign bodies should be removed at once. If S. pyogenes is isolated, a β-lactam plus clindamycin for 14 days is the most effective antibiotic treatment. If methicillin-resistant S. aureus (MRSA) is suspected or confirmed, vancomycin, daptomycin, linezolid, or tigecycline is indicated. Large amounts of intravenous fluid to raise the patient's blood pressure. Research has suggested that highly absorbent tampons increase the risk of TSS. Doctors advise patients to not use superabsorbent tampons during menstruation and maintenance of personal hygiene.