Toxic shock syndrome (TSS) is a rare and potentially fatal complication of infection by the Staphylococcus aureus or Streptococcus pyogenes bacteria. These bacteria can cause skin infections in burn patients or those undergoing surgery. However, TSS is mostly diagnosed in menstruating women who use superabsorbent (intravaginal) tampons, menstrual sponges and cervical caps. Toxins invade the bloodstream and organs, resulting in the multiorgan symptoms of TSS. The acute condition progresses quickly, and recognizing symptoms is vital to treatment in the hospital and the prevention of further complications.
Symptoms of Infection
If TSS occurs as a result of a soft tissue wound, symptoms of the bacterial infection may accompany those of the syndrome. Symptoms of a staph or strep infection at the site of a wound include intense, possibly radiating, pain, redness, inflammation, tenderness, warmth, and draining fluid.
An inflamed, widespread skin rash is one of the characteristic symptoms of toxic shock syndrome. The rash is similar to a sunburn and often covers most of the body. It may appear within hours of the release of bacterial toxins. Within one or two weeks, the rash turns scaly, and the skin begins to peel. Peeling skin most often occurs on the palms and the soles of the feet.
Disturbances of the gastrointestinal system because the bacterial toxins travel to the digestive tract. Those with the syndrome may feel nauseous or experience vomiting or persistent watery diarrhea. Because these symptoms are common in several minor illnesses and conditions, gastrointestinal upset is often not immediately connected to TSS. Nonetheless, nausea, vomiting, and diarrhea caused by TSS require immediate medical attention, especially if the symptoms accompany a soft-tissue wound or tampon use.
TSS shares several symptoms with the flu and may be mistaken for the respiratory illness in its early stages. These symptoms include fever, headache, chills, muscle aches, and sore throat and occur as a result of the immune system response to the toxin. An abrupt fever of 102 degrees Fahrenheit or higher is a hallmark symptom of TSS.
Malaise is the clinical term for feeling generally ill. People with TSS often feel tired, uncomfortable, and altogether unwell. Similar to symptoms resembling the flu, the body’s immune response causes malaise. Feeling ill often also occurs as a result of other symptoms of TSS, including vomiting, diarrhea, headache, and fever.
Blood Flow and Clotting Disturbances
When the toxin invades the bloodstream, it reduces the number of platelets. Fewer platelets means the blood’s ability to effectively clot is inhibited, causing coagulopathy, which results in bruised skin and increased blood flow, particularly to the mouth, eyes, and vagina. These areas, therefore, become a deep red color.
Central Nervous System Disturbances
Bacterial toxins may travel to the brain and the spinal cord, affecting the central nervous system (CNS) and resulting in cognitive and behavioral symptoms. When toxic shock syndrome affects the CNS, a person will feel dizzy, drowsy, and listless. He or she might also exhibit signs of altered mental state, including confusion, and disorientation, and disruption of thinking, attention, and arousal.
Kidney or renal failure can be life-threatening and may occur due to TSS. Symptoms of kidney failure include decreased urine output and evidence of particles or pus in the urine. These symptoms indicate a disruption in the ability of the kidneys to clean and filter blood. Kidney failure is fatal if left untreated.
Toxins released by a staph or strep infection may travel to the lungs and develop into acute respiratory distress syndrome (ARDS). People who develop ARDS as a complication of TSS experience shortness of breath, wheezing, and mottled or blue skin, due to a lack of oxygen. The decrease of oxygen and the release of proteins by injured lung cells may lead to inflammation of other organs, including the brain and heart.
Low Blood Pressure and Shock
Low blood pressure or hypotension and shock are the most acute and critical symptoms of toxic shock syndrome. TSS can lead to a dramatic drop in blood pressure, starving cells and organs of oxygen and nutrients. Symptoms of shock include a rapid heartbeat, shortness of breath, low body temperature, and limbs that are cool to the touch. Untreated shock may lead to organ damage or death.