Toxic Shock Syndrome (TSS) is a rare potentially life-threatening infection is caused by the presence of a bacteria Staphylococcus aureus and Streptococcus pyogenes that can grow and release exotoxins into the bloodstream if conditions are favorable. The symptoms of TSS are a high fever, vomiting, diarrhea, a sunburn-like rash, red eyes, dizziness, lightheadedness, muscle aches and low blood pressure. In a severe case, TSS can cause kidney and liver failure – any of these symptoms requires immediate medical care. TSS occurs in approximately 1 in 100,000 people. 30-50% cases are fatal. Menstruating women and post-partum women are at a greater risk of developing the infection.
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. Aggressive fluid management, ventilation, renal replacement therapy and inotropic support are essential as supportive care. Research has suggested that the risk of tampon-related TSS may be associated with tampon absorbency. Women are advised to use the tampon with the lowest absorbency. The risk of TSS can be greatly reduced by wearing a tampon for a maximum of 4 to 8 hours.