What Are the Symptoms of Toxic Shock Syndrome?

Toxic shock syndrome (TSS) is rare, but it can be life-threatening, so it’s important to know its signs and symptoms so you can spot it and treat it quickly.

Since TSS puts out toxins into your bloodstream, it can affect many different systems in your body at once. The symptoms are a lot like ones you might see from other kinds of infections: swelling, fever, redness, and a general feeling of being unwell.

TSS symptoms usually come on quickly, about 2 days after the bacteria infects you. The way TSS affects your body depends on the type of bacteria causing your condition.

Generally, TSS causes:

  • Fever
  • Rash
  • Low blood pressure
  • Kidney problems or failure
  • Respiratory problems or failure
  • Confusion

In order to figure out what kind of TSS you have, and to rule out other causes of infection or disease, your doctor will check for symptoms that are specific to certain types of bacteria. The bacteria that most commonly cause TSS are:

  • Staphylococcus aureus
  • Streptococcus pyogenes
  • Clostridium sordellii (C. sordellii)

Staphylococcal TSS Symptoms

Staphylococcal TSS happens most often in women. Sometimes, you can get it if you use superabsorbent tampons, and the bacteria gets trapped for too long in your vagina. You’re also more at risk if you have an infection after surgery, childbirth, or have burns or pus buildup in your body. This type of TSS causes:

  • Fever above 102 F
  • Headache
  • Fatigue
  • Flat, red rash like a sunburn on most of your body
  • Vomiting
  • Diarrhea
  • Muscle pain
  • Redder than usual mouth, eyes, and vagina
  • Bruising
  • Low urine output

You may also start to shed your skin in sheets, usually on the palms of your hands or soles of your feet, 1 to 2 weeks after your symptoms start.

Streptococcal TSS Symptoms

This kind of TSS usually happens after you have chickenpox, a skin infection, or if you have a weak immune system. The first symptom is most often severe pain that comes on suddenly. Other symptoms include:

  • Very low blood pressure
  • Shock (not enough blood flow to the systems in your body)
  • Bleeding problems
  • Bruising
  • Flat, red rash like a sunburn on most of your body
  • Trouble breathing

You may also have sheets of skin shed off, like in staphylococcal TSS, but this doesn’t always happen.

C. sordellii TSS Symptoms

Clostridium sordellii infection happens in the uterus. You can also get it from IV drug use. Its symptoms include:

  • Nausea and vomiting
  • Low energy and weakness
  • Flu-like symptoms
  • Pain when you touch your abdomen
  • Swelling
  • High red and white blood cell count
  • Fast heart rate

Unlike the other most common types of TSS, such as staphylococcal TSS, C. sordellii does not usually cause a fever.


  1. https://www.webmd.com/women/guide/what-are-toxic-shock-syndrome-symptoms
  2. Stanford Children’s Health: “Toxic Shock Syndrome.”
  3. Cleveland Clinic: “Toxic Shock Syndrome.”
  4. Medscape: “Toxic Shock Syndrome.”
  5. Johns Hopkins Medicine: “Toxic Shock Syndrome (TSS).”

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