Can TS be cured

Toxic shock syndrome (Tampon disease, TSS)

Toxic shock syndrome is an acutely occurring and rapidly progressing disease that is caused by bacteria and can be life-threatening if left untreated.

Short version:


  • The TSS is mainly caused by two different types of bacteria: Staphylococcus aureus and Streptococcus pyogenes.
  • It is a very rare, but nonetheless life-threatening disease.
  • In women, it is often related to tampon use.
  • If the syndrome is detected early, there is a good chance of recovery.

While it used to be more commonly associated with the use of tampons, today - following changes in tampon manufacture - it is very rare: it is estimated that around 3 out of 100,000 women develop TSS today.

Which pathogens trigger a TSS?

Toxic shock syndrome is a disease caused by toxins from two types of bacteria:

Staphylococcus aureus

Staphylococci occur in small amounts on the mucous membranes of the nose and vagina, but without causing any symptoms of the disease. The colonization of the mucous membranes alone does not pose a health risk - but carriers have an increased risk of infections caused by staphylococcus. Certain strains of staphylococci are able to produce poisons (toxins) that can cause great damage to the body under certain circumstances.

  • Menstruation-dependent TSS

The use of tampons can promote the formation of toxins by staphylococci: particularly absorbent tampons bind magnesium and thus change the vaginal environment. Staphylococci can produce more toxins in this low-magnesium environment. In addition, the disruption of the mucous membrane barrier makes it easier for the toxins to pass into the bloodstream or the uterus.

  • Non-menstrual TSS

This form of TSS can arise from any staphylococcal infection and thus affect women, men and children alike. Foci of infection are wounds, vaginal infections after childbirth or a miscarriage or skin infections from burns or the like.

+++ More on the topic: Staphylococci +++

Group A streptococci (Streptococcus pyogenes)

Streptococci occur naturally on the skin and mucous membranes. They are common pathogens of purulent infections such as pharyngitis (including scarlet fever), tonsillitis, various wound and skin infections, and triggers of non-purulent secondary diseases such as acute rheumatic fever and acute glomerulonephritis.

What are the risk factors?

  • Age: It is noticeable that younger women in particular develop TSS; this is likely due to immaturity of the immune system.
  • Pre-existing staphylococcal colonization of the vagina
  • Use of highly absorbent tampons
  • leaving the tampon in the vagina for too long or forgetting to do so
  • Use of contraceptive sponges, membranes or diaphragms

What are the symptoms of Toxic Shock Syndrome?

It usually starts very suddenly with a high and persistent fever (39–40.5 ° C), headache, and drowsiness. The rapid progression of the disease is typical of TSS: the shock-related sharp drop in blood pressure can lead to functional disorders of the internal organs (liver, kidneys, heart, lungs) and even multiple organ failure within a few days.

Often two or more organ systems are affected. In many cases, diffuse skin changes that resemble sunburn also occur.

Depending on which type of bacteria caused the TSS, additional, specific symptoms occur:

TSS due to staphylococci

A TSS caused by staphylococci is usually less severe, 97% of all affected patients can be cured. With this form of TSS, symptoms such as vomiting, diarrhea, confusion and, after a few days, flaking of the skin on the soles of the hands and feet occur more frequently. The blood count shows increased CK values ​​(creatine kinase), damage to the liver cells and a reduction in blood platelets.

TSS due to strep

Patients with streptococcal TSS have a significantly poorer prognosis. In addition to severe pain at the site of the infection, acute respiratory distress syndrome occurs in half of the patients. In addition, there is severe liver damage with subsequent bleeding disorders.

How is the diagnosis made?

The diagnosis of "toxic shock syndrome" is usually made on the basis of the symptoms and the pathogen detection. For this purpose, samples are taken from the suspicious infection site (wound, nose, throat, vagina) and examined for the presence of the pathogen. In the case of a streptococcal infection, the pathogen can also be detected in the blood. If the focus of infection is inside the body, it can be localized by an MRI or CT examination.

How is TSS treated?

Toxic shock syndrome must be treated immediately as it can trigger multiple organ failure.

++ More on the topic: Treatment of Toxic Shock Syndrome ++

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Astrid Leitner
Medical review:
Dr. Ludwig Kaspar
Editorial editing:
Mag. Julia Wild

Status of medical information:

ICD-10: A48.3