In the late seventies and early eighties the toxic shock syndrome (TSS) became epidemic among young menstruating women. A strong correlation was found between TSS and the rising popularity of hyperabsorbent tampons. Exotoxin-producing Staphylococcus aureus is seen as the main mediator of TSS in controlled clinical trials. Menstrual and nonmenstrual forms of TSS are differentiated. The nonmenstrual form is comparatively rare and has a high rate of mortality rate. Several studies showed that the overall incidence of menstrual and nonmenstrual TSS is approximately 1–3 cases per 100 000 persons. The leading symptoms are fever, hypotension, mucous membrane hyperemia, diffuse rashes, myalgias, vomiting and diarrhea. The severe form of the syndrome leads to multiorgan dysfunction. The streptococcal TSS (STSS) caused by group A Streptococci is clinically similar to the staphylococcal TSS. Both Staphylococcus aureus and Streptococci produce the exotoxin TSST-1. New methods allow the detection of TSST-1 production. However, due to the low incidence of TSS, this method of detection has not yet been taken up in the routine diagnostic procedures.