Hello, To have a better understanding of the situation let s first understand what is Toxic shock syndrome actually is and how it could be caused. Toxic shock syndrome (TSS) is a serious infection which is caused when the bacterium Staphylococcus aureus gets into the bloodstream and produces toxins. Staph is normally and harmlessly present in the vagina as a part of vaginal flora. How staph causes toxic shock syndrome is not understood. But there are two conditions which are necessary: First, the bacteria need an environment in which they can grow rapidly and release the poisons. Then the poisons must get into the bloodstream. A tampon saturated with blood is a supportive place for the rapid growth of bacteria. The bacterial poisons may then enter the bloodstream through tears in the vaginal wall or ruptured tiny blood vessels and these this too could be related to tampon use while sliding the tampon into place it could cause microscopic tears in the wall of the vagina or rupture tiny blood vessels. You need to be watching out for any of the following signs and symptoms: - Having body aches or muscle aches - Sudden high fever - A headache - Disorientation - Vomiting - Diarrhea - Any signs of dropping in your blood pressure like dizziness or lightheadedness - Convulsions - Red, sunburn-like rash on the palms and bottoms of your feet. If you experience any of the above-mentioned symptoms it’s best to head to an urgent care clinic or emergency room right away. In the hospital, they may be able to make a diagnosis of toxic shock syndrome based on a physical examination and your symptoms. Also, your doctor may check your blood and urine for traces of Staphylococcus or Streptococcus bacteria. They also may require a blood test to check your liver and kidney function. They may also take swabs of cells from your cervix, vagina, and throat. These samples are analyzed for the bacteria that cause toxic shock syndrome. The fact that you have not experienced any adverse symptoms is assuring and a good sign, however, it s better to play it safe and have yourself checked anyway since 2 days is considered too long for the tampoon to be left without being replaced or removed. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ramy Hafez, General & Family Physician