Toxic shock syndrome: the great masquerader

BMJ Case Rep. 2018 Nov 28;11(1):e226123. doi: 10.1136/bcr-2018-226123.

Abstract

Toxic shock syndrome is a rare but potentially lethal toxin-mediated illness that can be caused by streptococcal and staphylococcal species. It initially presents as a febrile illness that rapidly progresses to multiorgan dysfunction, hence a high index of suspicion coupled with rapid verification of the diagnosis and aggressive treatment is required to improve the outcome of the disease. A 23-year-old man presented with high-grade fever associated with headache, retro-orbital pain, gastroenteritis and gum bleeds. Treatment was initiated keeping in mind the possibility of dengue haemorrhagic fever. However, further clinical deterioration led us to re-examine our patient, revealing an old neglected wound. Microbiological confirmation of methicillin-resistant Staphylococcus aureus from the wound swab and prompt institution of appropriate treatment led to a favourable outcome in a case known to be associated with serious morbidity and mortality.

Keywords: dermatology; tropical medicine (infectious disease).

Publication types

  • Case Reports

MeSH terms

  • Humans
  • Male
  • Methicillin-Resistant Staphylococcus aureus*
  • Shock, Septic / microbiology*
  • Staphylococcal Infections / microbiology*
  • Wound Infection / microbiology*
  • Young Adult