A serious disorder characterised by high fever, diarrhoea, SHOCK and a rash. There may be organ failure, such as renal failure. It is caused by production of a toxin from an infecting staphylococcus, which happens to carry the TSST gene that encodes for production of the toxin (see STAPHYLOCOCCUS, TOXINS). It has been described most frequently with the use of tampons (see TAMPON), but has also been linked to the use of contraceptives such as the diaphragm, cap and sponge (see under CONTRACEPTION), and skin wounds, for example from ear piercing, tight football boots and by secondary infection of the skin lesions of varicella (CHICKENPOX).

Treatment consists of intensive care measures to combat shock and eradication of the staphylococcus by high-dose intravenous ANTIBIOTICS. The design of tampons has been improved. Recurrence of the disorder has been reported, and women who have had an episode should stop using tampons and vaginal contraceptives.