Describe the presentation of toxic shock syndrome.

Toxic shock syndrome is an acute febrile illness due to Staphylococcus aureus strains that produce pyrogenic exotoxins. These toxin-producing strains have been isolated classically from superabsorbent tampons in menstruating women but are also found in abscesses, wound infections, or the vaginas of nonmenstruating women.

Clinically, the hallmarks are fever, hypotension, and a diffuse erythema that resembles scarlet fever. Other manifestations include pharyngeal erythema, strawberry tongue, conjunctival infection, and gastrointestinal symptoms. Desquamation of the palms and soles occurs 1 to 2 weeks following resolution of the erythema.