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Toxic Shock Syndrome (TSS)

Toxic shock syndrome (TSS) is a rare but sometimes fatal disease that occurs mainly in menstruating women who use tampons.

Toxic shock syndrome (TSS) is caused by a toxinproducing strain of bacteria called Staphylococcus aureus that can accumulate in the vagina during menstruation. Women who use high-absorbency tampons or leave a tampon in place for an extended period are at increased risk for TSS. There have also been several reported cases of TSS associated with the use of the contraceptive sponge or diaphragm. Treatment of TSS usually involves a hospital stay with intravenous fluids, antibiotics, and flushing of the vagina to reduce the level of toxin-producing bacteria. A teenager who experiences an episode of TSS faces a 30% chance of a repeat episode sometime in the future.

TSS is characterized by the following symptoms during menstruation:

• sudden high fever (over 101°F ); nausea, vomiting, or diarrhea; blotchy, red rash that resembles sunburn; sudden drop in blood pressure (usually indicated by lightheadedness or fainting); lethargy or disorientation; severe muscle ache; and redness of the eyes, mouth, throat, or vagina.

Any woman who experiences these symptoms during tampon use should remove the tampon immediately and seek medical attention.

—Gail B. Slap, M.D.
University of Pennsylvania School of Medicine