WellSpan Home

Toxic Shock Syndrome Bacteria

Topic Overview

The two most common bacteria found in the diagnosis of toxic shock syndrome (TSS) are Streptococcus pyogenes (group A strep) or Staphylococcus aureus (staph). In some cases of TSS, the strep or staph bacteria may cause a serious infection in the body, such as pneumonia, osteomyelitis, or endocarditis.

Strep TSS is not as likely as staph TSS to come back. A person with staph TSS has an increased chance for getting it again.

Streptococcus pyogenes (group A strep)

Strep TSS may be related to:

  • Chickenpox (varicella). Children with chickenpox have a higher chance of getting TSS.
  • Advanced age. Older adults have a higher chance of getting TSS.
  • Diabetes , heart or lung disease, HIV, alcohol use, or intravenous (IV) drug use. People with these conditions have a higher chance of getting TSS.

But strep TSS can develop in people who have no risk factors.

Symptoms of strep TSS include:

Group A strep bacteria can be identified by cultures from a sample of blood or cerebrospinal fluid (CSF) or by a tissue biopsy. Cultures from the throat, the vagina, or a sputum sample may also contain the bacteria.

Staphylococcal aureus (staph)

In adults, staph may be part of the normal body bacteria on the skin and in the nose and vagina. More than 90% of adults have developed antibodies to the staph bacteria toxin that causes TSS. For those who have not developed an immunity and contract a staph infection, toxic shock syndrome may be related to:

  • Prolonged use of a tampon, typically a superabsorbent type.
  • The presence of a foreign body at the site of infection.
  • Infection after surgery, generally from a person's own staph bacteria.

Symptoms of staph TSS include:

  • Sudden fever over 102°F (38.89°C).
  • Red rash that is widespread over the body.
  • Dangerously low blood pressure (hypotension). The first sign of this life-threatening condition can be dizziness when rising from a sitting or lying position (orthostatic hypotension).
  • Involvement of more than one organ system. This is indicated by the presence of three or more of the following symptoms:
    • Vomiting or diarrhea
    • Severe muscle ache or pain
    • Confusion or decreased level of consciousness
    • Extremely red mucous membranes in the mouth, nose, throat, eye, or vagina
  • Skin tissue shedding, especially from the palms of the hands and the soles of the feet, 7 to 14 days after a rash begins.

Related Information


ByHealthwise Staff
Primary Medical ReviewerE. Gregory Thompson, MD - Internal Medicine
Adam Husney, MD - Family Medicine
Specialist Medical ReviewerDennis L. Stevens, MD, PhD - Internal Medicine, Infectious Disease

Current as ofNovember 18, 2017

Are you sure you would like to cancel?

All information will be lost.

Yes No ×

About the provider search

This search will provide you with WellSpan Medical Group and Northern Lancaster County (Ephrata) Medical Group primary care physicians and specialists. If we don’t have a WellSpan Medical Group physician to meet your criteria, the search will expand to include community physicians who partner with WellSpan Medical Group physicians through the WellSpan Provider Network or provide care to patients on the Medical Staffs of WellSpan’s Hospitals.


Schedule Your Next Appointment Online with MyWellSpan

Use your MyWellSpan patient portal any time to view available appointments, and pick the date and time that best suits your schedule.

Go to MyWellSpan

New to this practice?

If you don't have a WellSpan primary care provider and would like to schedule a new patient appointment with a provider who is accepting patients, just log into your MyWellSpan account, and go to the Appointment Center section. As you progress through the scheduling process, you will be able to see the offices that are accepting new patients in relation to your zip code. If you are not enrolled in MyWellSpan, go to https://my.wellspan.org, call 1-866-638-1842 or speak with a member of the staff at a participating facility to sign up. New patient scheduling not available at all practices/programs.

Already a patient at this practice?

If you already have a relationship with a WellSpan practice, simply log into your account, and go to the Appointment Center section. As you progress through the scheduling process, you will be able to schedule an appointment with any provider or practice that already counts you as a patient. Online scheduling varies by practice/program.