Toxic shock syndrome from staphylococcal pharyngitis

The case of a 27-year-old woman with fever, nasopharyngitis, systemic rash, hypotension, and eventually a positive throat culture for staphylococcus aureus is reviewed. Desquamation of her palms and axillae occurred one week following her illness. Despite inconclusive diagnostic testing for enterotoxin and endotoxin, we feel this presentation was consistent with toxic shock syndrome. The history and current literature regarding TSS are reviewed. This entity consists of a constellation of signs and symptoms whose diagnosis depends on the physician's suspicion and intuition.