What are the key clinical features to recognize Toxic Shock Syndrome (TSS) in a primary care setting?

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 ². A hallmark of TSS is the presence of shock, which can be a primary manifestation, alongside other signs of severe infection ² (Wang et al., 2024).

Key features often include a sudden high temperature or fever ²,³. Patients typically develop a diffuse erythematous rash, which may appear similar to sunburn ². 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 ².

Beyond these, TSS can involve multiple organ systems, leading to symptoms such as vomiting, diarrhoea, muscle pain, and altered mental status ². Recognizing these signs of severe infection and potential organ dysfunction is vital, as suspected TSS warrants urgent hospital admission for further management ².