Toxic-shock-like-syndrome due to Streptococcus pneumoniae sinusitis

We describe a patient with Streptococcus pneumoniae sinusitis associated with a severe sepsis syndrome and desquamative rash whose clinical illness strongly resembled toxic-shock syndrome. Assay of convalescent serum for antibodies to toxic-shock syndrome toxin 1 was negative. This case suggests the possibility of an additional bacterial pathogen associated with toxic-shock syndrome.