Cause

The strep or staph bacteria that produce the toxins that cause toxic shock syndrome (TSS) are common, but they are usually not harmful. Most of the time, these bacteria cause only mild infections of the throat, such as strep throat, or of the skin, such as impetigo. In rare cases, however, the toxins produced by the bacteria enter the bloodstream and cause a severe, rapidly progressing immune reaction.

The immune reaction that leads to toxic shock syndrome is typically linked to a lack of specific antibodies against a strep or staph toxin. Younger people are less likely than adults to have developed these antibodies.

Outbreaks of TSS can occur in hospitals and long-term care facilities where people live in close surroundings.