Materiały źródłowe

• #1 Toxic Shock Syndrome (TSS): Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/15437-toxic-shock-syndrome

  Toxic shock syndrome (TSS) is a rare but serious condition caused by certain strains of bacteria. […] It causes toxins to spread into the bloodstream, causing severe organ damage or death. […] Toxic shock syndrome (TSS) is a rare but potentially life-threatening condition caused by certain strains of bacteria that produce poisons (toxins). […] Most cases of toxic shock syndrome are caused by a toxin produced by Staphylococcus aureus (staph infection) and streptococcus pyogenes (group A strep infection). […] Clostridium sordellii can also cause toxic shock syndrome, but it’s less common. […] Under normal circumstances, these bacteria live on your skin or on your mucous membranes (like your throat or mouth) without causing any ill effects. […] However, under certain conditions, some strains of bacteria may start to grow rapidly and produce toxins.

• #1 Toxic Shock Syndrome: A Literature Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10812596/

  Toxic shock syndrome (TSS) is a rare, life-threatening, toxin-mediated infectious process linked, in the vast majority of cases, to toxin-producing strains of Staphylococcus aureus or Streptococcus pyogenes. […] The occurrence of TSS is linked to the bacterial secretion of superantigenic exotoxins, which are bacterial virulence factors genetically encoded and secreted. […] The main described superantigenic exotoxins are toxic shock syndrome toxin1 (TSST-1) and enterotoxins for Staphylococcus aureus and Streptococcal pyrogenic exotoxins (SpE) A, B, and C and streptococcal superantigen A (SsA) for Streptococcus pyogenes. […] Staphylococcal TSS can be menstrual or nonmenstrual. […] Streptococcal TSS is linked to a severe group A streptococcal infection and, most frequently, to a necrotizing soft tissue infection.

• #1 Toxic shock syndrome (TSS) | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/toxic-shock-syndrome-tss

  Toxic shock syndrome (TSS) is a rare and potentially life-threatening illness that is thought to be caused by infection with certain types of bacteria, including Staphylococcus aureus and Streptococcus pyogenes. […] The underlying mechanisms are not fully understood, but one theory is that the bacteria naturally present in the vagina can over-grow in the presence of a blood-soaked tampon. […] It is the toxin made by the bacteria that causes TSS, rather than the actual presence of the bacteria. […] For TSS to occur, these particular types of bacteria must first over-grow and make large amounts of the TSS toxin, which then enters the bloodstream. […] Tampons can increase the risk of TSS in two ways, including: Tampons (especially super-absorbent varieties) that are left in the vagina for a long time may encourage the bacteria to grow. […] Given the number of women worldwide who regularly use tampons, TSS is a very rare condition. […] There are no clinical trials supporting the use of menstrual cups to reduce the risk of TSS.

• #1 Toxic Shock Syndrome (TSS): Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/15437-toxic-shock-syndrome

  Toxic shock syndrome can occur when bacteria gets into open wounds, cuts or sores on your body. […] The following bacteria cause TSS: Staphylococcus aureus (S. aureus or staph): This bacteria typically lives on your body. […] Streptococcus pyogenes (S. pyogenes or group A strep): This type of bacteria causes toxic shock syndrome in people who have recently had strep throat, scarlet fever, impetigo or other infections caused by group A strep. […] Clostridium sordellii (C. sordellii): A bacteria typically found in your vagina enters your uterus during menstruation, childbirth or other gynecological procedures. […] Toxic shock syndrome is serious and life-threatening. […] Toxic shock syndrome won’t go away on its own. […] Most cases of toxic shock syndrome are associated with the use of highly absorbent tampons. […] However, cases of toxic shock syndrome also occur in non-menstruating people. […] Toxic shock syndrome can lead to death in 30% to 70% of cases.

• #1 Toxic Shock Syndrome (TSS): Signs, Causes and Treatment

  https://resources.healthgrades.com/right-care/infections-and-contagious-diseases/toxic-shock-syndrome

  Toxic shock syndrome (TSS) occurs due to a bacterial infection, typically from strep A. The condition can develop when the bacteria enter the body, although it is rare. […] Bacteria enter the body either through a break in the skin, such as injury, or through mucous membranes. […] According to the CDC, the main areas where bacteria enter the body in cases of TSS include: the vagina, which is why tampon use can introduce the bacteria; the pharynx, or the nasal passages; mucosa; skin and soft tissue. […] The CDC also notes that in up to 50% of cases, it is unclear how the bacteria entered the body.

• #1 Toxic shock syndrome: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000653.htm

  Toxic shock syndrome is caused by a toxin produced by some types of staphylococcus bacteria. A similar problem, called toxic shock-like syndrome (TSLS), can be caused by a toxin from streptococcal bacteria. Very few staph or strep infections cause toxic shock syndrome. […] The earliest cases of toxic shock syndrome involved women who used tampons during their menstrual periods. However, today less than one half of cases are linked to tampon use. Toxic shock syndrome can also occur with skin infections, burns, and after surgery. The condition can also affect children, postmenopausal women, and men. […] Risk factors include: Recent childbirth, Infection with Staphylococcus aureus (S aureus), commonly called a staph infection, Foreign bodies or packings (such as those used to stop nosebleeds) inside the body, Recent surgery, Tampon use (with higher risk if you leave one in for a long time), Wound infection after surgery.

• #1 Toxic shock syndrome (TSS) – including symptoms, treatment and prevention | SA Health

  https://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/conditions/infectious+diseases/toxic+shock+syndrome/toxic+shock+syndrome+tss+-+including+symptoms+treatment+and+prevention

  Toxic shock syndrome (TSS) is a very rare but potentially serious illness that can affect males or females at any age, but is more common during adolescence. It is caused by particular strains of bacteria called Staphylococcus aureus (and less commonly Streptococcus pyogenes) which are able to produce a toxin. […] The majority of cases of TSS occur in women during menstruation, mostly associated with tampon use. There is no evidence that tampons directly cause TSS the bacteria Staphylococcus aureus are the cause of the illness not the tampon. This explains why women using pads, men and children can get TSS. However, women who use tampons during their period have a higher risk of TSS than women who do not. […] In more than 30% of cases, no obvious bacterial infection can be found.

• #1 Toxic Shock Syndrome: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/169177-overview

  Toxic shock syndrome (TSS) is a rare acute life-threatening illness, caused by a toxin-mediated infectious process linked to toxin-producing strains of Staphylococcus aureus or group A Streptococcus (GAS), also called Streptococcus pyogenes. […] Notably, 50% of cases of TSS are not associated with menstruation. Nonmenstrual cases of TSS usually complicate the use of barrier contraceptives, surgical and postpartum wound infections, burns, cutaneous lesions, osteomyelitis, and arthritis. […] TSS is linked mostly to toxin-producing strains of Staphylococcus aureus and Streptococcus pyogenes (group A streptococcus). These toxins act as superantigens in inducing nonclassic activation of T cells by antigen-presenting cells (APCs), leading to nonspecific, polyclonal lymphocyte activation of 5-30% of the total population of T cells, which results in massive release of proinflammatory cytokines.

• #1 Toxic Shock Syndrome (TSS) – Infectious Diseases – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/infectious-diseases/gram-positive-cocci/toxic-shock-syndrome-tss

  Toxic shock syndrome is caused by staphylococcal or streptococcal exotoxins. […] Toxic shock syndrome (TSS) is caused by exotoxin-producing cocci. Strains of phage-group 1 Staphylococcus aureus elaborate the TSS toxin-1 (TSST-1) or related exotoxins; certain strains of Streptococcus pyogenes produce at least 2 exotoxins. […] Staphylococcal TSS has also been reported in both men and women with any type of S. aureus infection. […] Streptococcal TSS is similar to that caused by Staphylococcus aureus, but mortality is higher (20 to 60%) despite aggressive therapy. […] S. pyogenes TSS is defined as any group A beta-hemolytic streptococci (GABHS) infection associated with shock and organ failure. […] Risk factors for GABHS TSS include minor trauma, surgical procedures, viral infections (eg, varicella), use of nonsteroidal anti-inflammatory drugs (NSAIDs), diabetes, and alcohol use disorder. […] Toxic shock syndrome (TSS) is caused by exotoxin-producing strains of Staphylococcus aureus and Streptococcus pyogenes. […] Although classically described as occurring with tampon use, TSS may occur after many staphylococcal or streptococcal soft-tissue infections.

• #1 Toxic Shock Syndrome – Symptoms and Causes | familydoctor.org

  https://familydoctor.org/condition/toxic-shock-syndrome/

  Toxic shock syndrome (TSS) is an uncommon but serious, life-threatening complication of certain types of infections. It is caused by either staph (Staphylococcus aureus) bacteria or strep (Streptococcus pyogenes) bacteria. The bacteria produce toxins that can quickly lead to organ failure and even death. […] Most cases of toxic shock syndrome are caused by a toxin that is produced by staph bacteria. Some cases are caused by a toxin from strep bacteria. Not all staph or strep infections lead to toxic shock syndrome. […] Toxic shock syndrome gained national attention in the late 1970s. It was tied to tampon use during a woman’s menstrual period. Newer research shows using a tampon for longer than the recommended time without changing it can create the perfect environment for a staph infection. […] Toxic shock syndrome can also occur for other reasons. It can occur when a wound from a burn or surgery doesn’t heal properly. It can also happen from a skin infection, just after childbirth, and even in the case of a serious nosebleed that requires the use of packed medical gauze to stop it.

• #1 Toxic Shock Syndrome (TSS): Symptoms, Causes & More

  https://www.thecut.com/article/everything-you-should-know-about-tampons-tss.html

  Research estimates TSS occurs in about one in 100,000 women per year, according to the National Organization for Rare Disorders. […] The symptoms of TSS include high fever, rash, desquamation (when the patient sheds their skin in large sheets), muscle aches, vomiting or diarrhea, confusion, low blood pressure, and, later, multiple organ failure (usually the kidneys and liver). […] The recommendation by gynecologists is to use the lowest absorbency you can (and, yes, the terms regular, super, and super plus are standardized). Minkin says it doesn’t matter if the tampon is made of synthetic or natural fibers. Researchers don’t know how many women have the staph bacteria in their vaginal flora. While you could easily have cultures taken at your next doctor’s appointment, Minkin says vaginal flora change throughout your cycle, so you would need regular, ongoing cultures to check for it (which, she says, aren’t necessary for prevention). “The most important thing is to change your tampon regularly,” she says. “Don’t leave it in all day, you know, and keep it in there forever. It’s a sort of silly idea but give your vagina a chance to breathe.”

• #1 What You Need To Know About Toxic Shock Syndrome | University of Utah Health

  https://healthcare.utah.edu/healthfeed/2018/07/what-you-need-know-about-toxic-shock-syndrome

  TSS is a rare but serious bacterial illness. In the U.S., TSS is estimated to affect 3-6 people per 100,000 per year. […] The most common causes are Staphlococcus aureus and Streptococcus pyogenes. „People can be exposed to these bacteria through open wounds, surgery, tampon use, childbirth, and various types of infections,” said Clark. „Tampon use is to blame in only a fraction of cases.” […] „Manufacturers have reduced the absorbency of tampons and have changed the materials in order to decrease the risk,” said Clark. „By changing the type of tampons on the market, and through public education, the incidence of TSS in menstruating women declined dramatically.”

• #1 Toxic shock syndrome – Wikipedia

  https://en.wikipedia.org/wiki/Toxic_shock_syndrome

  It was shown later that higher absorbency of tampons was associated with an increased risk for TSS, regardless of the chemical composition or the brand of the tampon. […] Toxic shock syndrome is commonly known to be an issue for those who menstruate, although fifty percent of toxic shock syndrome cases are unrelated to menstruation. TSS in these cases can be caused by skin wounds, surgical sites, nasal packing, and burns.

• #1 Toxic Shock Syndrome: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/169177-overview

  Risk factors for the development of staphylococcal TSS are tampon use, vaginal colonization with toxin-producing S aureus, and lack of serum antibody to the staphylococcal toxin. […] The portal of entry for streptococci is unknown in almost one half of the cases. Procedures such as suction lipectomy, hysterectomy, vaginal delivery, and bone pinning have been identified as the portal of entry in many cases.

• #1 Reddit – The heart of the internet

  https://www.reddit.com/r/TwoXChromosomes/comments/1gc64js/common_misconception_toxic_shock_syndrome_tss/

  Oxygen is required for TSST-1 production; S. aureus can grow anaerobically through fermentation, but TSST-1 production requires oxidative metabolism. […] The initial epidemic of TSS was noticed when Rely released a new super-absorbent material in tampons, which released a ton of oxygen during absorption. […] Importantly, oxygen is required for TSST-1 production; S. aureus can grow anaerobically through fermentation, but TSST-1 production requires oxidative metabolism. The 1983 study by Schlievert and Blomster suggested that the role of tampons in mTSS was to introduce oxygen into a usually anaerobic environment. This would also explain why the risk for mTSS in general increases with tampon absorbency, namely, through the introduction of more oxygen in the tampon. […] The theory that TSS is caused by microabrasions has been disproven. As it stands, it seems that the bacteria that causes TSS can go through your mucosal vaginal wall without a problem, and tampons that don’t cause microulceratons are also able to cause TSS.

• #1

  https://reverehealth.com/live-better/causes-symptoms-and-treatment-of-toxic-shock-syndrome-2/

  Toxic shock syndrome (TSS) is a condition caused by certain strains of bacteria that release toxins into the bloodstream. The strains that cause toxic shock syndrome are staph (Staphylococcus aureus) bacteria and strep (Streptococcus pyogenes) bacteria. […] Although TSS is rare, it is a serious and potentially life-threatening condition that can result in the failure of vital organs, such as the liver, lungs or heart. […] Historically, TSS was most commonly associated with the use of super-absorbent tampons or using a tampon for longer than the recommended time without changing it. […] Despite the association between tampon use and TSS, it is important to know that anyone is at risk for TSS, not just menstruating women. […] TSS can progress rapidly and create complications, including shock, organ failure and even death. […] If you think you have TSS, seek immediate medical attention you may need to be hospitalized. […] Fortunately, you can prevent TSS. […] Quickly and deeply cleaning any wounds is also critical in preventing TSS.

• #1 What Causes Toxic Shock Syndrome? – BuzzRx

  https://www.buzzrx.com/blog/what-causes-toxic-shock-syndrome

  Nonetheless, TSS most often occurs in the setting of menstruation, despite super absorbent tampons being discontinued. […] TSS is a medical emergency. […] You can lower your risk of toxic shock syndrome by using sanitary napkins to catch blood flow (menstrual flow) and minimizing the use of tampons and other foreign bodies in the vagina, such as diaphragms, sponges, and menstrual cups.

• #1 Toxic shock syndrome

  https://www.nj.gov/health/womenshealth/reproductive-health/periods-menstruation/toxic-shock-syndrome/

  Toxic shock syndrome (TSS) could be a potentially life-threatening condition caused by certain strains of bacteria, most commonly Staphylococcus aureus (Staph) or Streptococcus pyogenes (Strep). Affecting both men and women, it is often associated with women who use tampons. […] TSS can be caused by the release of toxins from bacteria growing in the body. Factors that may increase the risk of TSS include: Using super-absorbent tampons, Leaving tampons in for an extended period, Using high-absorbency menstrual cups, Skin wounds or burns, Recent surgery, Certain types of bacterial infections. […] Immediate medical attention is crucial, if TSS is suspected. Treatment typically involves hospitalization, where antibiotics are administered to fight the bacterial infection. Other interventions may be required to stabilize blood pressure and support organ function.

• #2 Toxic Shock Syndrome: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/169177-overview

  Toxic shock syndrome (TSS) is a rare acute life-threatening illness, caused by a toxin-mediated infectious process linked to toxin-producing strains of Staphylococcus aureus or group A Streptococcus (GAS), also called Streptococcus pyogenes. […] Notably, 50% of cases of TSS are not associated with menstruation. Nonmenstrual cases of TSS usually complicate the use of barrier contraceptives, surgical and postpartum wound infections, burns, cutaneous lesions, osteomyelitis, and arthritis. […] TSS is linked mostly to toxin-producing strains of Staphylococcus aureus and Streptococcus pyogenes (group A streptococcus). These toxins act as superantigens in inducing nonclassic activation of T cells by antigen-presenting cells (APCs), leading to nonspecific, polyclonal lymphocyte activation of 5-30% of the total population of T cells, which results in massive release of proinflammatory cytokines.

• #2 Toxic Shock Syndrome (TSS): Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/15437-toxic-shock-syndrome

  Toxic shock syndrome can occur when bacteria gets into open wounds, cuts or sores on your body. […] The following bacteria cause TSS: Staphylococcus aureus (S. aureus or staph): This bacteria typically lives on your body. […] Streptococcus pyogenes (S. pyogenes or group A strep): This type of bacteria causes toxic shock syndrome in people who have recently had strep throat, scarlet fever, impetigo or other infections caused by group A strep. […] Clostridium sordellii (C. sordellii): A bacteria typically found in your vagina enters your uterus during menstruation, childbirth or other gynecological procedures. […] Toxic shock syndrome is serious and life-threatening. […] Toxic shock syndrome won’t go away on its own. […] Most cases of toxic shock syndrome are associated with the use of highly absorbent tampons. […] However, cases of toxic shock syndrome also occur in non-menstruating people. […] Toxic shock syndrome can lead to death in 30% to 70% of cases.

• #2 Toxic Shock Syndrome | GLOWM

  https://www.glowm.com/section-view/heading/Toxic%20Shock%20Syndrome/item/28

  The accepted cause of TSS is TSST-1. This toxin has had several names, including staphylococcal enterotoxin F and pyrogenic exotoxin C. TSST-1 is produced by at least 90% of S. aureus strains recovered from menses-associated cases but only 40% to 80% of non-menses-associated strains. These observations, combined with the results of animal models, suggest that there may be other TSS toxins or that aspects of microbe-toxin-host interactions, including host genomic susceptibilities, may play yet to be discovered roles in producing TSS. Staphylococcal enterotoxins B (SEB), C, E, and possibly others share biologic properties with TSST-1 and are structurally similar to streptococcal exotoxin A (i.e. erythrogenic or scarlet fever toxin). Schlievert was the first to observe that up to 78% of non-menses-associated strains of Staphylococcus produced TSST-1, SEB, or both and to suggest that SEB or other exotoxins are important in the pathogenesis of TSS or TSS-like disease. Crass and Bergdoll demonstrated that coagulase-negative staphylococci (from S. saprophyticus and S. epidermidis) can produce TSST-1 and other implicated enterotoxins.

• #2 Toxic Shock Syndrome: A Literature Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10812596/

  The interest of polyclonal intravenous immunoglobulin G administration as an adjunctive treatment for TSS requires further evaluation. […] The disease occurs after penetration of the exotoxin-producing S. pyogenes through a skin or mucous barrier alteration. […] The main superantigenic exotoxins described in S. pyogenes are streptococcal pyrogenic exotoxins (SpE) A, B, and C and streptococcal superantigen A (SsA).

• #2 Toxic Shock Syndrome (TSS)

  https://healthlibrary.vidanthealth.com/wellness/Stress/Tools/85,P00653

  Toxic shock syndrome (TSS) is an illness that produces symptoms in many systems of the body. Certain bacterial infections release toxins into the bloodstream. These toxins can spread to many body organs. This can cause severe damage and illness. […] The bacteria listed below are the main causes of TSS. […] These bacteria may normally exist on the surface of a person’s body and may not cause infection. But if there is a cut, burn, or other injury, they may enter the wound and cause a localized or spreading infection. […] TSS from S. pyogenes is most commonly seen in children and older adults. This type of TSS may happen from a cut, injury, or other local infection. […] These bacteria normally exist in the vagina and don’t cause infection. They may enter the uterus during normal menstruation, childbirth, or gynecological procedures, such as abortion. […] TSS can be caused by Staphylococcus aureus, Streptococcus pyogenes, or Clostridium sordellii.

• #2 Toxic Shock Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459345/

  TSS is most commonly caused by a toxigenic strain of Staphylococcus aureus or Group A Strep (Streptococcus pyogenes). […] The disease occurs most often in the setting of menstruation despite the discontinuation of high absorbency tampons. […] However, TSS can also present in non-menstrual settings such as in soft tissue infections, post-surgical infections, burns, retained foreign bodies such as nasal packing, and dialysis catheters. […] Staphylococcal TSS is typically the result of a localized infection such as an abscess, whereas streptococcal TSS may result from bacteremia, necrotizing fasciitis, or cellulitis.

• #2 Toxic shock syndrome Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/diseases-conditions/toxic-shock-syndrome

  Toxic shock syndrome is caused by a toxin produced by some types of staphylococcus bacteria. A similar problem, called toxic shock-like syndrome (TSLS), can be caused by a toxin from streptococcal bacteria. Very few staph or strep infections cause toxic shock syndrome. […] The earliest cases of toxic shock syndrome involved women who used tampons during their menstrual periods. However, today less than one half of cases are linked to tampon use. Toxic shock syndrome can also occur with skin infections, burns, and after surgery. The condition can also affect children, postmenopausal women, and men.

• #2 Spike in Toxic Shock causes a concern for all | SSM Health

  https://www.ssmhealth.com/newsroom/blogs/ssm-health-matters/february-2023/wisconsin%E2%80%99s-recent-toxic-shock-syndrome-cases

  The Wisconsin Department of Health Services has received five reports of Toxic Shock Syndrome since July 2022. Four of the five cases are associated with super-absorbent tampon use in teenage girls, who may be more likely to leave tampons in for prolonged periods of time. […] TSS is a serious illness most often caused by Staph aureus and sometimes caused by Strep pyogenes, both of which produce toxins. […] Dr. Miller says half of all cases are linked to menstruation, but this syndrome can also result from infected wounds from surgery, kitchen injuries or even working in the yard. […] Proctor and Gamble quickly removed the product from the market. The incidence of TSS fell rapidly, due to both the removal of the synthetic Rely product as well as greater public awareness of the disease.

• #2 What Everyone Should Know about Toxic Shock Syndrome (TSS)

  https://tampax.com/en-us/period-health/toxic-shock-syndrome-causes-treatment/

  Toxic Shock Syndrome, also known as TSS, is a rare, but serious infection that is caused by a specific strain of Staphylococcus aureus bacteria. […] Toxic Shock Syndrome is caused by bacteria, not tampons, specifically Staphylococcus aureus. […] Some other ways people develop TSS include insect bites, skin infections, or surgery. […] The only difference in tampons that can increase the risk for TSS is the absorbency. A higher absorbency tampon can increase the risk for TSS. […] If you’ve had tampon-related Toxic Shock Syndrome in the past, you should consult with your doctor before using tampons.

• #2 Toxic shock syndrome: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000653.htm

  Toxic shock syndrome is caused by a toxin produced by some types of staphylococcus bacteria. A similar problem, called toxic shock-like syndrome (TSLS), can be caused by a toxin from streptococcal bacteria. Very few staph or strep infections cause toxic shock syndrome. […] The earliest cases of toxic shock syndrome involved women who used tampons during their menstrual periods. However, today less than one half of cases are linked to tampon use. Toxic shock syndrome can also occur with skin infections, burns, and after surgery. The condition can also affect children, postmenopausal women, and men. […] Risk factors include: Recent childbirth, Infection with Staphylococcus aureus (S aureus), commonly called a staph infection, Foreign bodies or packings (such as those used to stop nosebleeds) inside the body, Recent surgery, Tampon use (with higher risk if you leave one in for a long time), Wound infection after surgery.

• #2 Toxic Shock Syndrome: A Literature Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10812596/

  Toxic shock syndrome (TSS) is a rare, life-threatening, toxin-mediated infectious process linked, in the vast majority of cases, to toxin-producing strains of Staphylococcus aureus or Streptococcus pyogenes. […] The occurrence of TSS is linked to the bacterial secretion of superantigenic exotoxins, which are bacterial virulence factors genetically encoded and secreted. […] The main described superantigenic exotoxins are toxic shock syndrome toxin1 (TSST-1) and enterotoxins for Staphylococcus aureus and Streptococcal pyrogenic exotoxins (SpE) A, B, and C and streptococcal superantigen A (SsA) for Streptococcus pyogenes. […] Staphylococcal TSS can be menstrual or nonmenstrual. […] Streptococcal TSS is linked to a severe group A streptococcal infection and, most frequently, to a necrotizing soft tissue infection.

• #2 Toxic shock syndrome: Symptoms, causes, and diagnosis

  https://www.medicalnewstoday.com/articles/175736

  Another is that the tampon fibers scratch the vagina, making it possible for bacteria to get through and into the bloodstream. […] Either the action or the composition of the tampons, combined with pre-existing staphylococcal bacteria in the vagina, probably trigger the disease. […] However, both there is no compelling evidence to support either of these. […] Streptococcal TSS can develop after minor trauma, or surgery, or as a result of a viral infection or the use of non-steroidal anti-inflammatory drugs (NSAIDS). […] The bacteria enter the body through wounds, localized infections, the vagina, the throat, or burns. The bacteria produce toxins that enter the bloodstream and spread to all the organs. […] TSS does not only develop in young menstruating women. It can affect older women, men, and children. Women who have been using a diaphragm or a contraceptive sponge have a slightly higher risk of developing TSS. Anyone with a staph or strep infection has the potential to develop TSS, but it is rare for this to happen.

• #2 Toxic Shock Syndrome (TSS): Symptoms, Causes & More

  https://www.thecut.com/article/everything-you-should-know-about-tampons-tss.html

  Someone needs to have a specific strain of staph bacteria (Staphylococcus aureus) in order to contract toxic shock syndrome through tampon usage, says Minkin. If they do, the staph can multiply and produce a harmful toxin. […] At the condition’s peak in the late 1970s and early 1980s, there were about 200 yearly cases of TSS, Minkin says. A lot of them involved young girls and women who used tampons. Experts came to the conclusion that the staph could multiply in the tampon’s fibers, often superabsorbent ones, producing the toxin. “It was a terrible thing. People didn’t know what it was and then they figured out it was related to this toxin produced by the organism,” she says. “The association was, ‘Oh my goodness. It must be related to tampon usage.” […] TSS can also occur following skin infections, burns, nosebleeds (where packing was used to absorb the blood), or after childbirth or surgery, according to the National Institutes of Health (NIH). While it’s not known how many cases of TSS are associated with tampon use, the NIH estimates that, in general, about half are menstruation related. “However, again, the key thing is that the number of cases of toxic shock syndrome in the United States these days is fortunately very small,” Minkin says.

• #2 What You Need To Know About Toxic Shock Syndrome | University of Utah Health

  https://healthcare.utah.edu/healthfeed/2018/07/what-you-need-know-about-toxic-shock-syndrome

  TSS is a rare but serious bacterial illness. In the U.S., TSS is estimated to affect 3-6 people per 100,000 per year. […] The most common causes are Staphlococcus aureus and Streptococcus pyogenes. „People can be exposed to these bacteria through open wounds, surgery, tampon use, childbirth, and various types of infections,” said Clark. „Tampon use is to blame in only a fraction of cases.” […] „Manufacturers have reduced the absorbency of tampons and have changed the materials in order to decrease the risk,” said Clark. „By changing the type of tampons on the market, and through public education, the incidence of TSS in menstruating women declined dramatically.”

• #2 Understanding Toxic Shock Syndrome: Causes, Prevention, and Treatment – Tulipon

  https://tulipon.com/understanding-toxic-shock-syndrome-causes-prevention-and-treatment/

  It was noted that tampons made with hyper-absorbable materials could lead to the accumulation of blood and an increase in vaginal pH, providing a favorable condition for bacterial growth. […] To prevent Toxic Shock Syndrome, it is essential to follow proper hygiene practices during menstruation. […] While TSS is a rare condition, it can have serious consequences, particularly for menstruating women. […] Recent research focusing on the effects of tampons and menstrual cups on S. aureus growth and toxin production provides valuable insights that can inform prevention strategies.

• #2 Toxic shock syndrome

  https://dermnetnz.org/topics/toxic-shock-syndrome-and-toxic-shock-like-syndrome

  Toxic shock syndrome is an uncommon but severe acute illness due to exotoxins produced by specific strains of Staphylococcus aureus or Streptococcus pyogenes. […] Toxic shock syndrome is caused by the release of exotoxins from toxigenic strains of the bacteria Staph aureus and Strep pyogenes in a person that lacks anti-toxin antibodies. […] Toxic shock syndrome starts from a localised staphylococcal infection which produces the causative exotoxins. […] Non-menstrual toxic shock syndrome is now the more common form and may occur as a complication of other localised or systemic infections such as pneumonia, osteomyelitis, sinusitis, and skin wounds (surgical, traumatic, or burns). […] Toxic shock syndrome associated with menstrual tampons is now relatively rare, as most adults have developed protective antibodies to the exotoxin TSST-1.

• #2 Reddit – The heart of the internet

  https://www.reddit.com/r/TwoXChromosomes/comments/1gc64js/common_misconception_toxic_shock_syndrome_tss/

  Oxygen is required for TSST-1 production; S. aureus can grow anaerobically through fermentation, but TSST-1 production requires oxidative metabolism. […] The initial epidemic of TSS was noticed when Rely released a new super-absorbent material in tampons, which released a ton of oxygen during absorption. […] Importantly, oxygen is required for TSST-1 production; S. aureus can grow anaerobically through fermentation, but TSST-1 production requires oxidative metabolism. The 1983 study by Schlievert and Blomster suggested that the role of tampons in mTSS was to introduce oxygen into a usually anaerobic environment. This would also explain why the risk for mTSS in general increases with tampon absorbency, namely, through the introduction of more oxygen in the tampon. […] The theory that TSS is caused by microabrasions has been disproven. As it stands, it seems that the bacteria that causes TSS can go through your mucosal vaginal wall without a problem, and tampons that don’t cause microulceratons are also able to cause TSS.

• #2

  https://www.healthychildren.org/English/health-issues/conditions/infections/Pages/Toxic-Shock-Syndrome.aspx

  Toxic shock syndrome (TSS) is a potentially deadly illness that is caused by toxins (poisons) made by 2 types of bacteria, Staphylococcus aureus and Streptococcus pyogenes (GAS). […] Although the use of tampons (particularly extended use) can still increase the chance of getting TSS, there are now fewer cases associated with tampons. Other risk factors have been identified, including recent use of barrier birth control methods (eg, diaphragm, vaginal sponge), surgical procedures, recently giving birth to a baby, and a current infection with bacteria such as S aureus. […] Toxic shock syndrome can affect many organs in the body, including the lungs, bowel, brain, and kidneys. Complications are caused by a decline in blood pressure (hypotension) as well as the direct action of the toxin, which makes organs of the body more likely to fail, leading to the need for respirators and dialysis. […] If your teenaged daughter uses tampons, she should choose them with care. Tampon manufacturers have changed the way they make their products to decrease their absorbency, and this has significantly lowered the number of TSS cases associated with tampon use.

• #2 Toxic Shock Syndrome – Harvard Health

  https://www.health.harvard.edu/diseases-and-conditions/toxic-shock-syndrome-a-to-z

  Toxic shock syndrome is a rare, life-threatening illness triggered by certain bacteria (group A streptococcal and Staphylococcus aureus). […] In some patients, these bacteria enter the body through an obvious break in the skin, such as a wound or puncture. Other cases are related to the use of tampons. […] Sometimes, however, toxic shock develops after a relatively mild injury, such as a bruise or muscle strain, or no cause is identified at all. […] Staphylococcal toxic shock that is related to tampon use can be avoided by changing tampons frequently. […] In some cases of toxic shock syndrome caused by group A streptococci, when there is extensive infection of soft tissues, surgical removal of destroyed tissue may be necessary.

• #3 Toxic Shock Syndrome (TSS) – Basics & Causes

  https://www.webmd.com/women/understanding-toxic-shock-syndrome-basics

  Toxic shock syndrome (TSS) is a sudden, potentially deadly condition caused when an overgrowth of bacteria releases toxins into your bloodstream. […] Two kinds of bacteria, Staphylococcus aureus and Streptococcus pyogenes, are to blame for most cases. […] Three different kinds of bacteria can cause TSS: Staphylococcus aureus (staph), Streptococcus pyogenes (group A strep), and Clostridium sordellii. […] TSS happens when certain conditions allow these bacteria to grow and spread quickly and start releasing poisons. Then they get into your bloodstream through a break in your skin or mucus membranes. […] Some things that can cause you to get TSS include: Tampon or other device left inside your vagina for too long, skin infection, postsurgical infection, childbirth, abortion, or other gynecological procedure, gauze or other packing used to stop a nosebleed or surgical bleeding.

• #3 Clinical Guidance for Streptococcal Toxic Shock Syndrome | Group A Strep | CDC

  https://www.cdc.gov/group-a-strep/hcp/clinical-guidance/streptococcal-toxic-shock-syndrome.html

  STSS is a disease defined as an infection with Streptococcus pyogenes accompanied by sudden onset of shock and organ failure. […] When the bacteria produce exotoxins and virulence factors in the deep tissues and bloodstream, it can induce the cytokine cascade. Massive cytokine cascades contribute to the development of shock or organ failure. […] Strains that produce certain virulence factors and exotoxins, particularly streptococcal pyrogenic exotoxins, are more likely to cause severe infections, including STSS1.

• #3 Toxic Shock Syndrome (TSS): Symptoms and Causes | RoRoRo

  https://ro.co/health-guide/toxic-shock-syndrome/

  Toxic shock syndrome is an illness that results from a bacterial infection. The illness is usually caused by strains of bacteria called Streptococcus pyogenes (Group A Streptococcus) or Staphylococcus aureus (although other strains are capable of causing TSS). […] These bacteria are called “superantigens” because they can produce toxins that cause higher-than-usual activation of the body’s immune system, and they can bypass T-cells, which are immune system cells that help defend the body from infection. […] This infection can become life-threatening if it spreads from the blood to the organs, where it can cause organ failure. […] While toxic shock syndrome is not confined to the improper use of tampons, it is what most people associate toxic shock syndrome with. […] One study found that using the same tampon for more than eight consecutive hours while sleeping overnight can increase the risk of TSS (sometimes referred to as menstrual toxic shock syndrome or mTSS).

• #3 Toxic Shock Syndrome: Why It Happens and How To Treat It

  https://www.verywellhealth.com/toxic-shock-syndrome-4175808

  While most toxic shock syndrome cases are associated with menstruation, it also occurs in people who are not menstruating (non-menstrual TSS). […] Non-menstrual causes include: Soft-tissue infections, Post-surgical infections, Retained foreign items, like nasal packing or catheters. […] TSS is a rare infection caused by streptococcal, staphylococcal, and clostridium bacteria.

• #3 Toxic Shock Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459345/

  TSS is most commonly caused by a toxigenic strain of Staphylococcus aureus or Group A Strep (Streptococcus pyogenes). […] The disease occurs most often in the setting of menstruation despite the discontinuation of high absorbency tampons. […] However, TSS can also present in non-menstrual settings such as in soft tissue infections, post-surgical infections, burns, retained foreign bodies such as nasal packing, and dialysis catheters. […] Staphylococcal TSS is typically the result of a localized infection such as an abscess, whereas streptococcal TSS may result from bacteremia, necrotizing fasciitis, or cellulitis.

• #3 Spike in Toxic Shock causes a concern for all | SSM Health

  https://www.ssmhealth.com/newsroom/blogs/ssm-health-matters/february-2023/wisconsin%E2%80%99s-recent-toxic-shock-syndrome-cases

  The Wisconsin Department of Health Services has received five reports of Toxic Shock Syndrome since July 2022. Four of the five cases are associated with super-absorbent tampon use in teenage girls, who may be more likely to leave tampons in for prolonged periods of time. […] TSS is a serious illness most often caused by Staph aureus and sometimes caused by Strep pyogenes, both of which produce toxins. […] Dr. Miller says half of all cases are linked to menstruation, but this syndrome can also result from infected wounds from surgery, kitchen injuries or even working in the yard. […] Proctor and Gamble quickly removed the product from the market. The incidence of TSS fell rapidly, due to both the removal of the synthetic Rely product as well as greater public awareness of the disease.

• #3 Toxic Shock Syndrome (TSS): Symptoms, Causes & More

  https://www.thecut.com/article/everything-you-should-know-about-tampons-tss.html

  Someone needs to have a specific strain of staph bacteria (Staphylococcus aureus) in order to contract toxic shock syndrome through tampon usage, says Minkin. If they do, the staph can multiply and produce a harmful toxin. […] At the condition’s peak in the late 1970s and early 1980s, there were about 200 yearly cases of TSS, Minkin says. A lot of them involved young girls and women who used tampons. Experts came to the conclusion that the staph could multiply in the tampon’s fibers, often superabsorbent ones, producing the toxin. “It was a terrible thing. People didn’t know what it was and then they figured out it was related to this toxin produced by the organism,” she says. “The association was, ‘Oh my goodness. It must be related to tampon usage.” […] TSS can also occur following skin infections, burns, nosebleeds (where packing was used to absorb the blood), or after childbirth or surgery, according to the National Institutes of Health (NIH). While it’s not known how many cases of TSS are associated with tampon use, the NIH estimates that, in general, about half are menstruation related. “However, again, the key thing is that the number of cases of toxic shock syndrome in the United States these days is fortunately very small,” Minkin says.

• #3 Understanding Toxic Shock Syndrome (TSS): Are Tampons the Cause? | Period Education Project

  https://periodeducationproject.org/2024/03/22/understanding-toxic-shock-syndrome-tss-are-tampons-the-cause/

  Toxic Shock Syndrome (TSS) is a rare but serious condition caused by bacteria, most commonly, Staphylococcus Aureus. […] It is the toxin made by the bacteria that causes TSS, rather than the bacteria alone or the presence of a tampon. […] By leaving a period product (tampon, menstrual cup, etc) in for too long, the bacteria have a chance to over-grow and produce large amounts of the TSS toxin, which then enters the bloodstream. […] During the 1980s, there was a peak in TSS cases and deaths, primarily due to tampons designed for increased absorbency. […] Ingredients such as polyester, carboxymethylcellulose, and polyacrylate rayon, which were used in these tampons, were associated with higher production of the TSS toxin.

• #3 Early suspicion of toxic shock syndrome

  https://emcrit.org/pulmcrit/early-suspicion-of-toxic-shock-syndrome/

  Staphylococcal TSS is classically associated with colonization of superabsorbant tampons. With discontinuation of these tampon brands in the 1980s, the incidence of menstrual staph TSS has declined, but this still constitutes about half of staph TSS cases. Nonmenstrual cases occur due to toxin secretion from various sources such as soft tissue infection, sinusitis or sinus packing, or pneumonia. […] Strep TSS may result from an occult focus of infection (e.g., small abscess). In these cases, the presentation will be dominated by toxigenic symptoms, and may resemble staph TSS. It may be impossible to distinguish these diseases initially, and therefore in practice it is often safest to treat empirically for both of them simultaneously. […] Staph TSS may be misdiagnosed as garden-variety septic shock. Prominent gastrointestinal symptoms or erythematous rash may be helpful clues if present. The degree of illness is typically out of proportion to the focus of infection. Poor response to standard treatments for sepsis can also suggest TSS.

• #3 Reddit – The heart of the internet

  https://www.reddit.com/r/TwoXChromosomes/comments/1gc64js/common_misconception_toxic_shock_syndrome_tss/

  Oxygen is required for TSST-1 production; S. aureus can grow anaerobically through fermentation, but TSST-1 production requires oxidative metabolism. […] The initial epidemic of TSS was noticed when Rely released a new super-absorbent material in tampons, which released a ton of oxygen during absorption. […] Importantly, oxygen is required for TSST-1 production; S. aureus can grow anaerobically through fermentation, but TSST-1 production requires oxidative metabolism. The 1983 study by Schlievert and Blomster suggested that the role of tampons in mTSS was to introduce oxygen into a usually anaerobic environment. This would also explain why the risk for mTSS in general increases with tampon absorbency, namely, through the introduction of more oxygen in the tampon. […] The theory that TSS is caused by microabrasions has been disproven. As it stands, it seems that the bacteria that causes TSS can go through your mucosal vaginal wall without a problem, and tampons that don’t cause microulceratons are also able to cause TSS.

• #3

  https://wukawear.com/blogs/periods-a-z/toxic-shock-syndrome

  Toxic shock syndrome happens when an overgrowth of bacteria called Staphylococcus aureus release toxins into the body. […] There are a handful of reasons why someone may contract toxic shock syndrome, one way is in relation to the products used during a monthly cycle. […] It can be caused by a tampon being left inside the vagina for too long, especially if you do not follow the guidelines on the tampon box which states the length of use (4-8 hours), or if you use super-absorbent tampons. […] Using menstrual sponges and female contraceptives, such as a diaphragm or a cervical cap, can lead to toxic shock syndrome. […] According to WebMD, researchers have ruled out other personal hygiene items and practices such as douching, lubricants, and sprays as a cause for TSS. […] They have also said that toxic shock syndrome is not related to drug and alcohol use, underwear, or sexual activity.

• #3 Toxic Shock Syndrome – Epidemiology

  https://www.vdh.virginia.gov/epidemiology/epidemiology-fact-sheets/toxic-shock-syndrome/

  Toxic shock syndrome (TSS) is a serious bacterial infection that affects many systems of the body. Staphylococcus aureus (commonly referred to as staph) and Streptococcus pyogenes (usually referred to as group A Streptococcus or strep) are the two bacteria most often associated with toxic shock syndrome. They can release toxins into the bloodstream. These toxins can spread to many body organs, causing illness and damage. […] TSS from S. pyogenes is most commonly seen in children and older adults. People may be at risk if they have cuts or open wounds, have an infection of the skin, or inject illegal drugs. Other people at risk are adults 65 years and older and people with diabetes, chronic lung disease, heart disease, or those have had a recent viral infection like chickenpox or shingles. […] Early recognition and treatment of staphylococcal and streptococcal infections can help prevent serious complications such as TSS.

• #4 Toxic shock syndrome

  https://www.nhs.uk/conditions/toxic-shock-syndrome/

  Toxic shock syndrome (TSS) is a rare infection. […] It’s possible to get TSS: from using tampons or menstrual cups, from a contraceptive diaphragm or cap, after a vaginal birth or caesarean section, from a cut, wound, boil or burn that has become infected. […] Your chances of getting TSS are higher if you’ve had it before.

• #4 Toxic Shock Syndrome | GLOWM

  https://www.glowm.com/section-view/heading/Toxic%20Shock%20Syndrome/item/28

  The accepted cause of TSS is TSST-1. This toxin has had several names, including staphylococcal enterotoxin F and pyrogenic exotoxin C. TSST-1 is produced by at least 90% of S. aureus strains recovered from menses-associated cases but only 40% to 80% of non-menses-associated strains. These observations, combined with the results of animal models, suggest that there may be other TSS toxins or that aspects of microbe-toxin-host interactions, including host genomic susceptibilities, may play yet to be discovered roles in producing TSS. Staphylococcal enterotoxins B (SEB), C, E, and possibly others share biologic properties with TSST-1 and are structurally similar to streptococcal exotoxin A (i.e. erythrogenic or scarlet fever toxin). Schlievert was the first to observe that up to 78% of non-menses-associated strains of Staphylococcus produced TSST-1, SEB, or both and to suggest that SEB or other exotoxins are important in the pathogenesis of TSS or TSS-like disease. Crass and Bergdoll demonstrated that coagulase-negative staphylococci (from S. saprophyticus and S. epidermidis) can produce TSST-1 and other implicated enterotoxins.

• #4 Toxic Shock Syndrome (TSS)

  https://healthlibrary.vidanthealth.com/wellness/Stress/Tools/85,P00653

  Toxic shock syndrome (TSS) is an illness that produces symptoms in many systems of the body. Certain bacterial infections release toxins into the bloodstream. These toxins can spread to many body organs. This can cause severe damage and illness. […] The bacteria listed below are the main causes of TSS. […] These bacteria may normally exist on the surface of a person’s body and may not cause infection. But if there is a cut, burn, or other injury, they may enter the wound and cause a localized or spreading infection. […] TSS from S. pyogenes is most commonly seen in children and older adults. This type of TSS may happen from a cut, injury, or other local infection. […] These bacteria normally exist in the vagina and don’t cause infection. They may enter the uterus during normal menstruation, childbirth, or gynecological procedures, such as abortion. […] TSS can be caused by Staphylococcus aureus, Streptococcus pyogenes, or Clostridium sordellii.

• #4 Toxic shock syndrome

  https://dermnetnz.org/topics/toxic-shock-syndrome-and-toxic-shock-like-syndrome

  Other risk factors include recent childbirth, miscarriage, or abortion, and the use of birth control devices such as the diaphragm or contraceptive sponges. […] Toxic shock syndrome diagnosis is confirmed if all 5 CDC clinical criteria are fulfilled. […] Treatment requires hospitalisation and intravenous antibiotics active against the causative organisms are given to eradicate the focus of the infection. […] The mortality rate of toxic shock syndrome is approximately 515%, and recurrences have been reported in as many as 3040% of cases.

• #4 Toxic Shock Syndrome (TSS): Symptoms, Causes & More

  https://www.thecut.com/article/everything-you-should-know-about-tampons-tss.html

  Research estimates TSS occurs in about one in 100,000 women per year, according to the National Organization for Rare Disorders. […] The symptoms of TSS include high fever, rash, desquamation (when the patient sheds their skin in large sheets), muscle aches, vomiting or diarrhea, confusion, low blood pressure, and, later, multiple organ failure (usually the kidneys and liver). […] The recommendation by gynecologists is to use the lowest absorbency you can (and, yes, the terms regular, super, and super plus are standardized). Minkin says it doesn’t matter if the tampon is made of synthetic or natural fibers. Researchers don’t know how many women have the staph bacteria in their vaginal flora. While you could easily have cultures taken at your next doctor’s appointment, Minkin says vaginal flora change throughout your cycle, so you would need regular, ongoing cultures to check for it (which, she says, aren’t necessary for prevention). “The most important thing is to change your tampon regularly,” she says. “Don’t leave it in all day, you know, and keep it in there forever. It’s a sort of silly idea but give your vagina a chance to breathe.”

• #4 Reddit – The heart of the internet

  https://www.reddit.com/r/TwoXChromosomes/comments/1gc64js/common_misconception_toxic_shock_syndrome_tss/

  COMMON MISCONCEPTION: Toxic Shock Syndrome (TSS) risk is NOT determined by the length of time you have a tampon inserted. It is mainly due to oxygen introduced by absorbent materials in a tampon, and the main risk is CONTINUOUS usage. […] The risk of TSS is VERY LOW, because to even get infected in the first place, you need to be colonized with a subtype of specific bacteria, and not have antibodies against it (most people do), so this probably applies to well under 1% of people. […] It is my understanding that continual usage (always having a tampon in) is actually a determinant of risk of TSS, as this can cause an increase in oxygen that can simulate the growth of the bacteria that cause TSS. […] Toxic Shock Syndrome is a condition most often caused by the bacteria Staphylococcus aureus, which produces the pyrogenic toxin superantigen TSS toxin 1 (TSST-1).

• #4

  https://reverehealth.com/live-better/causes-symptoms-and-treatment-of-toxic-shock-syndrome-2/

  Toxic shock syndrome (TSS) is a condition caused by certain strains of bacteria that release toxins into the bloodstream. The strains that cause toxic shock syndrome are staph (Staphylococcus aureus) bacteria and strep (Streptococcus pyogenes) bacteria. […] Although TSS is rare, it is a serious and potentially life-threatening condition that can result in the failure of vital organs, such as the liver, lungs or heart. […] Historically, TSS was most commonly associated with the use of super-absorbent tampons or using a tampon for longer than the recommended time without changing it. […] Despite the association between tampon use and TSS, it is important to know that anyone is at risk for TSS, not just menstruating women. […] TSS can progress rapidly and create complications, including shock, organ failure and even death. […] If you think you have TSS, seek immediate medical attention you may need to be hospitalized. […] Fortunately, you can prevent TSS. […] Quickly and deeply cleaning any wounds is also critical in preventing TSS.

• #5 Reddit – The heart of the internet

  https://www.reddit.com/r/TwoXChromosomes/comments/1gc64js/common_misconception_toxic_shock_syndrome_tss/

  COMMON MISCONCEPTION: Toxic Shock Syndrome (TSS) risk is NOT determined by the length of time you have a tampon inserted. It is mainly due to oxygen introduced by absorbent materials in a tampon, and the main risk is CONTINUOUS usage. […] The risk of TSS is VERY LOW, because to even get infected in the first place, you need to be colonized with a subtype of specific bacteria, and not have antibodies against it (most people do), so this probably applies to well under 1% of people. […] It is my understanding that continual usage (always having a tampon in) is actually a determinant of risk of TSS, as this can cause an increase in oxygen that can simulate the growth of the bacteria that cause TSS. […] Toxic Shock Syndrome is a condition most often caused by the bacteria Staphylococcus aureus, which produces the pyrogenic toxin superantigen TSS toxin 1 (TSST-1).

• #5 Toxic shock syndrome: Causes, symptoms, and prevention

  https://flo.health/menstrual-cycle/health/symptoms-and-diseases/toxic-shock-syndrome

  Alongside the risk of leaving in a tampon for more than eight hours, other factors can increase your risk of developing toxic shock, such as: Using female barrier contraceptives such as caps, diaphragms, or sponges (types of nonhormonal birth control). […] TSS is a life-threatening illness, and, in some cases, it can affect the major organs in your body. If the condition isnt treated, it can result in complications including shock and renal failure. […] Toxic shock syndrome develops very quickly.

• #5 Toxic shock syndrome

  https://dermnetnz.org/topics/toxic-shock-syndrome-and-toxic-shock-like-syndrome

  Other risk factors include recent childbirth, miscarriage, or abortion, and the use of birth control devices such as the diaphragm or contraceptive sponges. […] Toxic shock syndrome diagnosis is confirmed if all 5 CDC clinical criteria are fulfilled. […] Treatment requires hospitalisation and intravenous antibiotics active against the causative organisms are given to eradicate the focus of the infection. […] The mortality rate of toxic shock syndrome is approximately 515%, and recurrences have been reported in as many as 3040% of cases.

• #5 Toxic Shock Syndrome – Harvard Health

  https://www.health.harvard.edu/diseases-and-conditions/toxic-shock-syndrome-a-to-z

  Toxic shock syndrome is a rare, life-threatening illness triggered by certain bacteria (group A streptococcal and Staphylococcus aureus). […] In some patients, these bacteria enter the body through an obvious break in the skin, such as a wound or puncture. Other cases are related to the use of tampons. […] Sometimes, however, toxic shock develops after a relatively mild injury, such as a bruise or muscle strain, or no cause is identified at all. […] Staphylococcal toxic shock that is related to tampon use can be avoided by changing tampons frequently. […] In some cases of toxic shock syndrome caused by group A streptococci, when there is extensive infection of soft tissues, surgical removal of destroyed tissue may be necessary.

• #6 Reddit – The heart of the internet

  https://www.reddit.com/r/TwoXChromosomes/comments/1gc64js/common_misconception_toxic_shock_syndrome_tss/

  Oxygen is required for TSST-1 production; S. aureus can grow anaerobically through fermentation, but TSST-1 production requires oxidative metabolism. […] The initial epidemic of TSS was noticed when Rely released a new super-absorbent material in tampons, which released a ton of oxygen during absorption. […] Importantly, oxygen is required for TSST-1 production; S. aureus can grow anaerobically through fermentation, but TSST-1 production requires oxidative metabolism. The 1983 study by Schlievert and Blomster suggested that the role of tampons in mTSS was to introduce oxygen into a usually anaerobic environment. This would also explain why the risk for mTSS in general increases with tampon absorbency, namely, through the introduction of more oxygen in the tampon. […] The theory that TSS is caused by microabrasions has been disproven. As it stands, it seems that the bacteria that causes TSS can go through your mucosal vaginal wall without a problem, and tampons that don’t cause microulceratons are also able to cause TSS.

• #6 Toxic Shock Syndrome

  https://mobile.fpnotebook.com/ID/Fever/TxcShckSyndrm.htm

  Requires substantial Fluid Replacement due to capillary leak […] Highly absorbent tampons (especially those left in place for days) […] Onset of toxic shock within 5 days of Menses […] Responsible for 50% of Staphylococcal Toxic Shock cases […] Decreasing Incidence in the United States (since highly absorbent tampons are off the market) […] Upper Respiratory Infection (Acute Sinusitis, Acute Pharyngitis) […] Empyema or Pneumonia […] Peritonsillar Abscess […] Necrotizing Fasciitis or Cellulitis […] Superinfected Varicella Zoster Virus Infection […] Pregnancy increases toxic shock risk by 20 fold

• #7 Toxic Shock Syndrome (TSS) and menstrual products: a short history

  https://helloclue.com/articles/cycle-a-z/toxic-shock-syndrome-and-menstrual-products-a-short-history

  Toxic shock syndrome (TSS) is a rare but life-threatening condition caused by a toxin released by the bacteria Staphylococcus aureus and Streptococcus pyogenes. […] TSS associated with menstruation and the use of menstrual products is usually caused by staph bacteria. […] Why exactly TSS occurs is not very well understood. You need to have the bacteria to develop TSS, but just having the bacteria doesn’t mean you’ll get TSS. […] Usually, an interaction between having the bacteria and some factor causes TSS. […] For example, menstruation changes the pH of the vagina, making it easier for TSS bacteria to multiply. […] Tampons, including non-synthetics containing tampons, change the natural environment in the body. […] It has also been hypothesized that tampons, especially those with the now-banned synthetic components, may offer an ideal breeding ground for staph bacteria or may be digestible for bacteria and thus fuel proliferation. […] Tampons are the most common factor in menstrually-associated TSS, but anything you put into your body poses a potential risk as it may introduce bacteria and/or oxygen. […] Although TSS is a very serious condition, it’s fortunately rare.

• #7 Toxic Shock Syndrome (TSS) – Infectious Diseases – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/infectious-diseases/gram-positive-cocci/toxic-shock-syndrome-tss

  Toxic shock syndrome is caused by staphylococcal or streptococcal exotoxins. […] Toxic shock syndrome (TSS) is caused by exotoxin-producing cocci. Strains of phage-group 1 Staphylococcus aureus elaborate the TSS toxin-1 (TSST-1) or related exotoxins; certain strains of Streptococcus pyogenes produce at least 2 exotoxins. […] Staphylococcal TSS has also been reported in both men and women with any type of S. aureus infection. […] Streptococcal TSS is similar to that caused by Staphylococcus aureus, but mortality is higher (20 to 60%) despite aggressive therapy. […] S. pyogenes TSS is defined as any group A beta-hemolytic streptococci (GABHS) infection associated with shock and organ failure. […] Risk factors for GABHS TSS include minor trauma, surgical procedures, viral infections (eg, varicella), use of nonsteroidal anti-inflammatory drugs (NSAIDs), diabetes, and alcohol use disorder. […] Toxic shock syndrome (TSS) is caused by exotoxin-producing strains of Staphylococcus aureus and Streptococcus pyogenes. […] Although classically described as occurring with tampon use, TSS may occur after many staphylococcal or streptococcal soft-tissue infections.

• #8 Early suspicion of toxic shock syndrome

  https://emcrit.org/pulmcrit/early-suspicion-of-toxic-shock-syndrome/

  About 10-30% of all invasive group A streptococcal infections, and 50% of streptococcal necrotizing fasciitis, are complicated by TSS. This is an important consideration when treating any critically ill patient with invasive group A streptococcal infection. […] Pregnant women have 20-fold increased incidence of Group A Streptococcal infection, possibly due to changes in maternal immunity. Although infection is most often in the postpartum period, 15% precede delivery. Sites of infection include endometritis, necrotizing fasciitis, urinary tract, surgical sites, and breast. These may be complicated by TSS. Presentation typically includes abdominal pain, fever, and shock. […] Diagnosing TSS is challenging, and in some cases it is impossible to ever reach a definitive diagnosis. Some patients will not develop positive cultures, leaving TSS as a diagnosis of exclusion. Alternative possibilities such as meningococcemia, primary adrenal insufficiency, and other foci of infection must be carefully evaluated. It is essential to treat TSS as early as possible. Thus, in situations of diagnostic uncertainty, empiric treatment for TSS should be started while continuing to evaluate for alternative diagnoses.

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