Pustules on the back possibly triggering toxic-shock syndrome

We herein describe an irregular case of toxic-shock syndrome (TSS). A previously healthy 28-year-old Japanese man developed a sudden-onset high fever. The patient was suffering from conjunctival hyperaemia, gastrointestinal symptoms such as vomiting and diarrhoea, and systemically diffused macular erythroderma. Further physical examination detected pustules on his back, which self-destructed over time. Laboratory revealed multiple organ failures. Subsequently, scalded skin on the face and desquamation in the limb extremities emerged by day 10, leading to the diagnosis of TSS, despite his stable circulatory dynamics through the course. Learning points for clinicians include that they should recall TSS as a possible disease concurrently causing high fever, systemic rash and multiple organ dysfunctions, even without being in a state of shock. The characteristic desquamations emerged in the limb extremities after hospitalisation were of help in diagnosing TSS.

Toxic Shock Syndromes

10 Dermatologic Emergencies You Should Know About - Clinical Advisor

Staphylococcus aureus Infections - Infections - Merck Manuals Consumer Version

Streptococcal Toxic Shock Syndrome: All You Need to Know

How to tell if your rash is toxic shock syndrome

Toxic Epidermal Necrolysis (TEN): Background, Pathophysiology, Etiology

Streptococcal Toxic Shock Syndrome - StoryMD

Dermatology SpringerLink

How to tell if your rash is toxic shock syndrome

Staph infections - Symptoms & causes - Mayo Clinic

– Emergency Medicine EducationWhat's that Rash? An approach to dangerous rashes based on morphology - - Emergency Medicine Education