Table 3: Illnesses that may resemble Toxic Shock Syndrome
- Severe group A streptococcal infections (scarlet fever, necrotising fasciitis, toxic shock-like syndrome) 1
- Kawasaki syndrome 2
- Staphylococcal scalded skin syndrome 3
- Rocky Mountain spotted fever
- Gram-negative sepsis
- Exanthematous viral syndromes (e.g., rubeola, adenoviral infection, certain enteroviral infections, dengue)
- Severe allergic drug reactions;
1 Streptococcal toxic shock-like syndrome may be clinically indistinguishable from TSS. Extensive soft tissue destruction and exudativepharyngitis are suggestive of a streptococcal etiology.
2 Rare above the age of 4 years. Presents subacutely rather than acutely. Thrombocytosis (rather than thrombocytopenia) is common.
3 Rare above the age of 5 years. The skin may be diffusely tender, and sloughs early on. Systemic toxicity is rare.