Toxic shock syndrome: The great masquerader

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.