Toxic Shock Syndrome

Toxic shock syndrome(TSS) is a rare and fatal illness caused by different types of bacterial toxins. Earlier the cases of toxic shock syndrome involved women using their tampons during their periods (menstruation), but nowadays less than half of the current cases are associated with events involving it.


Toxic shock syndrome is caused by Streptococcus pyogenes and enterotoxin type B. Toxic shock syndrome, is sometimes also referred as streptococcal toxic shock syndrome (STSS) or toxic shock like syndrome (TSLS).


The bacterium Staphylococcus aureus which causes the Toxic shock syndrome typically manifests in individuals with high fever, along with low blood pressure, confusion and malaise, coma, and multiple organ failure. The rash which is often seen in the early phase of illness, resembles sunburn and could be found on any part of the body, which includes the mouth, lips, and eyes. The rash desquamates after 10-14 days in patients surviving the initial phase.


There is no specific test to diagnose for toxic shock syndrome. Blood and urine samples will be tested for the presence of a staph or strep infection. Samples from the cervix, vagina and throat may be swabbed for laboratory analysis.


The disease is severe and it frequently warrants hospitalization where patients will be admitted to the intensive care unit for supportive care like ventilation, aggressive fluid management, and renal replacement therapy especially in the case of multiple organ failure. The source of infection containing abscesses should be removed or drained, failing to do so will result in poorer outcomes among the patients.


With appropriate treatment, patients usually recover in two to three weeks. The condition can be fatal within hours.


Menstrual toxic shock syndrome can be prevented by avoiding the use of highly absorbent tampons. The risk could be reduced significantly by using tampons once in a while during menstruation and by changing them more frequently.

Treatment Cost

For patients having a health insurance, out-of-pocket costs for  the treatment of toxic shock syndrome  consist of doctor copays, laboratory copays and a hospital copay or coinsurance of 10%-50%. Toxic shock syndrome treatment is usually covered by health insurance.

For patients not covered by health insurance, treatment of toxic shock syndrome usually costs tens of thousands of dollars which include several days of hospitalization, doctor fees, laboratory fees and drug costs. A Study shows that the median total cost for the treatment of toxic shock syndrome was about $35,000 and was $115,000 or more for 10% of those patients.