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
  • Leptospirosis
  • Meningococcemia
  • 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.