Toxic shock syndrome
An acute bacterial infection, toxic shock syndrome (TSS) is caused by toxin-producing, penicillin-resistant strains of Staphylococcus aureus, such as TSS toxin-1 and staphylococcal enterotoxins B and C. The disease primarily affects menstruating women younger than age 30 and is associated with continuous use of tampons during the menstrual period.
TSS incidence peaked in the mid-1980s and has since declined, probably because of the withdrawal of high-absorbency tampons from the market.
Although tampons are clearly implicated in TSS, their exact role is uncertain. Theoretically, tampons may contribute to development of TSS by:
introducing S. aureus into the vagina during insertion
absorbing toxin from the vagina
traumatizing the vaginal mucosa during insertion, thus leading to infection
providing a favorable environment for the growth of S. aureus.
When TSS isn’t related to menstruation, it seems to be linked to S. aureus infections, such as abscesses, osteomyelitis, and postsurgical infections.