Skip to Content

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 ofMarch 3, 2017

This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use and Privacy Policy. Learn how we develop our content.

© 1995-2018 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.

Symptom Checker

Feeling under the weather?

Use our interactive symptom checker to evaluate your symptoms and determine appropriate action or treatment.

Symptom Checker

Decision Points

Our interactive Decision Points guide you through making key health decisions by combining medical information with your personal information.

You'll find Decision Points to help you answer questions about:

Interactive Tools

Get started learning more about your health!

Our Interactive Tools can help you make smart decisions for a healthier life. You'll find personal calculators and tools for health and fitness, lifestyle checkups, and pregnancy.