Doctors have issued a warning for vigilance around toxic shock syndrome (TSS) and tampon use after a teenage girl became severely ill during her period.
The 16-year-old spent six days in the intensive care unit of Our Lady of Lourdes Hospital in Drogheda after being admitted with fever, vomiting, a sore throat, low blood pressure and a rash.
Her heart was racing, her kidneys were not working properly and she was becoming confused and fainting.
Meningitis was quickly ruled out, but it took numerous tests to determine what was making her so ill.
She was eventually successfully treated with a large suite of medications and antibiotics.
TSS is rare and can occur with different kinds of infections but it is most associated with bacteria developing in the vagina.
The most common known cause is tampons being left in too long and, in the past, certain types of high-absorbency tampons that are no longer permitted.
In the Drogheda case, reported in the Irish Medical Journal, the patient had been using tampons but there was no evidence of prolonged tampon use.
She had inserted the first one 18 hours before being rushed to hospital but had felt ill before this.
That led doctors to highlight the incident with a warning that TSS can happen even with regularly changed menstrual products.
“This case demonstrates the importance of early recognition and management of TSS and reinforces that TSS can occur even without a retained tampon,” they said.
“Public awareness, safe tampon use, and early clinical suspicion remain critical in reducing TSS-related morbidity and mortality.”
The report cites research suggesting prolonged tampon use may be a risk factor for low-income women and girls in Ireland.
“In Ireland, 50 per cent of girls aged 12–19 reported occasional period poverty (defined as limited access to menstrual hygiene products due to financial constraints), which may lead to extended tampon use, with up to 85,000 women at risk,” the doctors reported.
The report says TSS is not a notifiable condition in Ireland so the true number of cases in unknown.
It draws attention to an inquest in 2024 that found a young Dublin mother had died of TSS linked to a tampon the previous year.
It says rare cases have also been reported associated with use of menstrual cups in other countries but no cases have been reported from use of period pants.