To recognise Toxic Shock Syndrome (TSS) in a primary care setting, it is crucial to identify a combination of key clinical features that indicate a severe systemic illness with rapid onset NICE NG51. A hallmark of TSS is the presence of shock, which can be a primary manifestation, alongside other signs of severe infection NICE NG51 Wang et al. 2024.
Key features often include a sudden high temperature or fever NICE NG51,NICE NG143. Patients typically develop a diffuse erythematous rash, which may appear similar to sunburn NICE NG51. Hypotension, indicating shock, is a critical diagnostic criterion and may present with signs of poor perfusion such as cold extremities, prolonged capillary refill time, or reduced urine output NICE NG51.
Beyond these, TSS can involve multiple organ systems, leading to symptoms such as vomiting, diarrhoea, muscle pain, and altered mental status NICE NG51. Recognizing these signs of severe infection and potential organ dysfunction is vital, as suspected TSS warrants urgent hospital admission for further management NICE NG51.
Key References
- CG84 - Diarrhoea and vomiting caused by gastroenteritis in under 5s: diagnosis and management
- NG51 - Suspected sepsis: recognition, diagnosis and early management
- NG143 - Fever in under 5s: assessment and initial management
- (Wang et al., 2024): Kawasaki disease with shock as the primary manifestation: How to distinguish from toxic shock syndrome?: A case report and literature review.