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Toxic shock syndrome — SCE Acute Medicine MCQ

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HardSepsis and Infectious EmergenciesToxic shock syndromeSCE Acute Medicine

A 28-year-old woman is assessed on the acute medical unit. She has fever, vomiting, diffuse erythematous rash and shock during menstruation. Creatinine is raised and platelets are falling. Initial assessment includes relevant observations, bedside tests and urgent blood results. What is the most likely diagnosis?

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Correct answer: C — Toxic shock syndrome

Toxic shock syndrome is the best answer because shock with fever, rash and multi-organ involvement suggests toxin-mediated toxic shock syndrome. Adrenal crisis is plausible, but it is less appropriate for the physiology or timing described in this stem. The other distractors either fit a neighbouring presentation, delay definitive treatment, or miss the key immediate risk. Clinical pearl: Source control and toxin-suppressing antibiotics are important.

Reference: https://www.gov.uk/government/organisations/uk-health-security-agency#acute-medicine-order-58-1