Snapshot A 19-year-old woman presents to the emergency department for worsening myalgias, chills, nausea, and generalized weakness. Her symptoms began approximately 5 days ago. She denies any recent travel history or sick contacts and states she is currently menstruating and using tampons. Her temperature is 102.0°F (38.9°C), blood pressure is 88/55 mmHg, and pulse is 115/min. Physical examination is remarkable for confusion and widespread macular blanching erythroderma that appears like a sunburn. Laboratory studies are significant for a leukocyte count of 17,000/mm3 with a neutrophilic predominance. Blood and urine cultures are obtained. She is admitted to the medical intensive care unit and is receiving aggressive fluid resuscitation and intravenous vancomycin and clindamycin. (Toxic shock syndrome caused by Staphylococcus aureus) Introduction Definition login to view 1 more bullet Epidemiology Incidence login to view 2 more bullets Etiology Pathophysiology login to view 6 more bullets Staphylococcus aureus Group A Streptococcus (Streptococcus pyogenes) Presentation Symptoms login to view 5 more bullets Physical exam login to view 6 more bullets Studies Labs login to view 11 more bullets Differential Other causes of sepsis login to view 9 more bullets Treatment Initial login to view 1 more bullet Conservative login to view 3 more bullets Medical login to view 10 more bullets Complications Multiorgan failure (e.g., renal dysfunction and central nervous system involvement