From the Research
Toxic Shock Syndrome (TSS) due to a retained tampon typically develops rapidly, with symptoms usually appearing within 2 to 5 days after tampon insertion, as supported by the most recent literature review 1. The onset of TSS can be as quick as 12 hours after insertion or as late as 1 to 2 weeks in cases where a tampon has been forgotten. Some key points to consider in the management and treatment of TSS include:
- Recognition of the syndrome, which is critical for prompt treatment
- Resuscitation and removal of the source of infection, such as a retained tampon
- Rational choice of antibiotics, including penicillinase-resistant penicillin, cephalosporin, or vancomycin, along with clindamycin or linezolid 2
- The role of adjunctive treatment, such as intravenous immunoglobulin, which may be considered in some cases 3 The rapid progression of TSS occurs because Staphylococcus aureus bacteria, which may naturally be present in the vagina, multiply in the tampon's absorbent material and release toxins that enter the bloodstream. These toxins trigger an overwhelming immune response that can lead to multi-organ failure if not treated promptly. To prevent TSS, tampons should be changed every 4-8 hours, and super-absorbent tampons should be avoided or used only during heavy flow days. Anyone experiencing symptoms of TSS while using tampons should remove the tampon immediately and seek emergency medical care. It is essential to note that TSS is a potentially deadly disease requiring prompt recognition and treatment, as highlighted in a review of the literature 2.