Toxic Shock Syndrome: Causes and symptoms

TSS is caused by a strain of Staphylococcus aureus found in the nose, mouth, and occasionally the vagina. The bacteria produce a characteristic toxin. In large enough quantities, the toxin can enter the bloodstream, causing a potentially fatal infection.

While experts know the name of the bacterium, more than 10 years after the 1980s epidemic scientists still do not fully understand the link between TSS and tampons. Most medical researchers today suspect that the absorbent tampons introduce oxygen into the vagina, which is normally an oxygen-free area of the body. Oxygen triggers bacterial growth, and the more absorbent the tampon, the more bacteria it can harbor. Some experts believe that the reason TSS is linked to tampons in particular is that bacteria can contaminate and multiply in a tampon. If left in place for a long time—as a woman could do with a super-absorbent product—the bacteria have a better chance of multiplying and producing a large amount of toxin. It is also possible that the tampons or the chemicals they contain may irritate the vaginal lining, enabling the toxin to enter the bloodstream.

These types of bacteria are normally present either on hands or in the vagina, and it takes an amount of bacteria only the size of a grain of sand to start an infection. Of the 15% of women who carry Staphylococcus aureus, only about 5% have the strain that produces the TSS toxin.

TSS. TSS begins suddenly, with a high fever of 102°F (38.9°C) or above, vomiting and watery diarrhea, headache, and sunburn-like rash; together with a sore throat and body aches. Blood pressure may plummet a day or two after the first symptoms appear. When the blood pressure drops, a woman may become disoriented or go into shock. Her kidneys may fail. After these developments, the skin on her hands and feet may peel.

STSS. STSS can occur after a streptococcal infection in the body, usually from an infected wound or even chickenpox. Within 48 hours, the patient's blood pressure drops. There is also fever, dizziness, breathing problems, and a weak, rapid pulse. The area around the wound may swell, the liver and kidneys can fail, and bleeding problems may occur.

— Carol A. Turkington