Toxic shock syndrome (TSS) is an acute life-threatening illness caused by infection with either Staphylococcus aureus or group AStreptococcus (GAS), also called Streptococcus pyogenes. It is characterized by high fever, rash, hypotension, multiorgan failure (involving at least 3 or more organ systems), and desquamation of the palms and soles, 1-2 weeks after the onset of acute illness. Estimates from population-based studies have documented an incidence of invasive GAS infection of 1.5-5.2 cases per 100,000 people annually. Approximately 8-14% of these patients also will develop TSS. Menstrual TSS is more likely in women using highly absorbent tampons.
TSS can be fatal and must be treated immediately. Supportive care like fluid supplement and dialysis help the patient recover quickly. Penicillin and other beta-lactam antibiotics are most efficacious against rapidly growing bacteria. Intravenous antibiotic combinations of pencillins and clindamycin are given to help prevent recurrence. With proper treatment, patients generally recover within three weeks. Patient education about early signs and symptoms, risk factors and avoidance of tampon use during menstruation may help prevent relapses.