Toxic Shock Syndrome Support Group

Toxic shock syndrome (TSS) is a rare but potentially fatal disease caused by a bacterial toxin. Different bacterial toxins may cause toxic shock syndrome, depending on the situation. The causative agent is Staphylococcus aureus. A similar condition, called Toxic Shock Like Syndrome (TSLS), is the result of Streptococcus pyogenes infection.

Symptoms of toxic shock syndrome (TSS) vary depending on the underlying cause; in either case, diagnosis is based strictly upon CDC criteria modified in 1981 after the initial surge in tampon-associated infections. TSS resultant of infection with the bacteria Staphylococcus aureus typically manifests in otherwise healthy individuals with high fever, accompanied by low blood pressure, malaise and confusion, which can rapidly progress to stupor, coma, and multi-organ failure. The characteristic rash, often seen early in the course of illness, resembles a sunburn, and can involve any region of the body, including the lips, mouth, eyes, palms and soles. In patients who survive the initial insult of infection, the rash begins to desquamate, or peel, after 10-14 days.

In contrast, TSLS (also referred to as Streptococcal TSS) caused by the bacteria Streptococcus pyogenes, typically presents in people with pre-existing skin infections with the bacteria. These individuals often experience severe pain at the site of the skin infection, followed by rapid progression of symptoms as described above for TSS. In contrast to TSS caused by Staphylococcus, Streptococcal TSS less often involves a sunburn-rash.

Diagnosis of TSS and Streptococcal TSS are strictly based on CDC criteria; in general, the presence of high fevers, low blood pressure, confusion, and laboratory evidence of organ failure in the appropriate historical setting (e.g. menstruating woman using tampon, or young individual with pre-existing skin infection), are necessary to make the diagnosis.