Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content + Download Section PDF Listen ++ For further information, see CMDT Part 33-04: Staphylococcus aureus Infections + Key Features Download Section PDF Listen +++ ++ Strains of staphylococci may produce toxins that can cause four important entities Scalded skin syndrome, typically in children, or bullous impetigo in adults Necrotizing pneumonitis in children Toxic shock syndrome (TSS) Enterotoxin food poisoning Most cases (≥ 90%) of TSS were initially reported in women of childbearing age, especially common within 5 days of the onset of a menstrual period in women who have used tampons Organisms from various sites, including the nasopharynx, bones, vagina, and rectum, or wounds have all been associated with the illness + Clinical Findings Download Section PDF Listen +++ ++ Toxic shock is characterized by abrupt onset of fever, vomiting, and watery diarrhea A diffuse macular erythematous rash and nonpurulent conjunctivitis are common, and desquamation, especially of the palms and soles, is typical during recovery + Diagnosis Download Section PDF Listen +++ ++ Blood cultures classically are negative because symptoms are due to the effects of the toxin and not to the invasive properties of the organism + Treatment Download Section PDF Listen +++ ++ Rapid rehydration, antistaphylococcal antibiotics (eg, parenteral nafcillin or oxacillin or, in the penicillin allergic patient, clindamycin), management of kidney or heart failure, and most importantly removal of sources of toxin (eg, removal of tampon, drainage of abscess) Intravenous clindamycin, 900 mg every 8 hours, is often added to inhibit toxin production Intravenous immune globulin may be considered, although there are limited data compared to streptococcus toxic shock syndrome