Toxic shock syndrome. Are you recognizing its changing presentations?

Nonmenstrual cases of toxic shock syndrome now occur at least as often as the classic menstrual cases. The syndrome has been reported in every conceivable clinical setting involving colonization or infection with Staphylococcus aureus and as a complication of surgical procedures, traumatic injuries, and local infections. Unusual clinical manifestations have been observed in patients with AIDS. Cases of toxic shock syndrome also have been linked to infection with toxin-producing strains of coagulase-negative staphylococci and group A streptococci. Knowledge of the expanding spectrum of toxic shock syndrome and early consideration of the disease in patients with fever, hypotension, rash, and/or multisystem disease are essential for timely diagnosis and optimum management.