Staphylococcus aureus is commonly found on the skin and mucous membranes of healthy adults and children and by age 25, 90% of the general population will have antibodies against the organism.1 Staphylococcal aureus is also known to be the causative agent to several infections that range from folliculitis, to abscess and endocarditis. In 1972, a syndrome of fever, myalgias, sore throat, edema, scarlatiniform rash, and desquamation associated with Staphylococcus aureus infection was first described. In 1978, Todd and colleagues reported seven cases in children who presented with similar symptoms as described in 1972 of fever, headache, conjunctival hyperemia, rash. These cases also presented with acute renal failure, hepatic abnormalities, DIC, and shock: “One patient died, one had gangrene of the toes, and all have had fine desquamation of affected skin and peeling of palms and soles.”3 Staphylococcus aureus was isolated from mucosal (nasopharyngeal, vaginal, tracheal) but not from blood and the term toxic shock syndrome (TSS) was coined.2,3 The peak incidence of Staphylococcus aureus related illness was seen in 1980 when 890 cases were reported, 91% of which were related to the use of super…show more content… The eyes could be involved prior to skin manifestations. Skin lesions can present with a wide range of appearances, occurring on the upper torso, limbs and face. Palms and soles are commonly involved. Skin lesions typically begin with ill-defined, erythematous macules with purpuric centers, although many cases of SJS/TEN may present with diffuse erythema.24 Nikolsky sign, which is easy removal of the epidermal surface with gentle pressure, is present. Nikolsky sign is a helpful clinical indicator, however not specific for SJS/TEN. The skin could be tender to touch before lesions
