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Toxic Shock Syndrome

When to call the doctor
  • Children
    • If a child has a fever   and a red rash with some of the symptoms of toxic shock syndrome, call the doctor to discuss the possibility of toxic shock syndrome.
    • The most common causes of a fever and a rash in children are viruses and scarlet fever, which affect children younger than 10 years. Scarlet fever is a form of strep throat that causes a sore throat   and a raised (bumpy) rash, not the flat rash of toxic shock syndrome. Scarlet fever is not usually a serious illness, and it is safe to wait until morning to call and visit the doctor.
    • If a child has severe nausea, vomiting, diarrhea  , or all three, call the doctor to discuss the symptoms of dehydration  .
  • Adults
    • If a high fever is present without a rash, as well as some of the symptoms of toxic shock syndrome, call the doctor.
    • Many viral illnesses can cause fever and sore throat, cough, malaise, nausea and vomiting, diarrhea, and muscle aches.
When to go to the hospital

Children: Take a child to the pediatrician or the hospital's emergency department if he or she has a fever, has a flat (not bumpy) rash, is not acting normally, seems confused, is short of breath, or faints.

Adults: If fever is present with some of the toxic shock syndrome symptoms  , along with a red rash, proceed to the hospital's emergency department for evaluation. Have someone else drive, especially if feeling lightheaded or confused. Women who are menstruating and using a tampon should remove the tampon prior to going to the hospital.

Self-Care at Home

People with suspected toxic shock syndrome should be immediately taken to the hospital's emergency department. Women who are menstruating and using tampons should remove the tampon prior to going to the hospital.


  • Skin effects
    • People who have toxic shock syndrome can expect their superficial skin to peel off about 1-2 weeks after the illness.
    • Half of those with toxic shock syndrome lose some or all of their hair and nails about 2-3 months after the illness. Hair and nails usually grow back on their own.
  • Recurrence
    • Repeat episodes occur about 4-6 months after the initial episode in up to half of all people who have had toxic shock syndrome. These recurrences are usually not as dangerous but still must be taken seriously and treated in the hospital.

Women can prevent menstrual-related toxic shock syndrome by not using tampons, especially the superabsorbent variety.

All wounds should be kept clean and monitored for signs of infection.


Toxic shock syndrome is a serious, life-threatening disease. Early medical care is the key to ensuring the best possibility of survival. People who survive toxic shock syndrome usually improve within 48 hours and can be discharged from the hospital within 1 week.

  • Staphylococcal toxic shock syndrome: Less than 5% of women with toxic shock syndrome caused by S aureus (including menstrual related) die.
  • Streptococcal toxic shock syndrome: The form of toxic shock syndrome caused by S pyogenes is more severe and causes death in about 30% of people.


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