TSS1 toxic shock syndrome

Toxic shock syndrome can occur when certain bacteria produce toxins that trigger a powerful body-wide response. It has been associated with tampon use, menstrual cups, wounds, burns, surgery, and skin or vaginal infections, although the source is not always obvious.

Possible features include sudden fever, vomiting or diarrhoea, muscle aches, headache, dizziness, confusion, a sunburn-like rash, and very low blood pressure. Later, skin may peel, particularly on the hands or feet. These symptoms can resemble other illnesses, so diagnosis requires urgent clinical assessment.

If toxic shock syndrome is suspected, remove a tampon or menstrual cup if one is in place and seek emergency care immediately. Do not wait to see whether symptoms settle, and do not drive yourself if you feel faint, confused, or severely unwell.

Hospital treatment may include intravenous fluids, antibiotics, monitoring, and treatment for the source of infection. Tell clinicians about recent surgery, wounds, vaginal products, medicines, and any infection symptoms.

Call emergency services for a sudden severe illness with fever plus faintness, confusion, breathing difficulty, a widespread rash, repeated vomiting, or rapidly worsening pain. Urgent help is appropriate even if a tampon or cup has already been removed.

Ask what source of infection was found, how long treatment is expected to continue, which warning signs require returning to hospital, and how to use menstrual products safely in future.