a 25 year old female presented to the hospital on 3rdday of menstruation with complaints of high fever vomiting and rash on her trunk and extremities. on investigations she had leukocytosis and negative blood culture. she is diagnosed as :

TOXIC SHOCK SYNDROME Toxic shock syndrome (TSS) is an acute, febrile illness produced by a bacterial exotoxin, with a fulminating downhill course involving dysfunction of multiple organ systems. It is not unusual for the syndrome to develop from a site of bacterial colonization rather than from an infection. A woman with TSS may develop rapid onset of hypotension associated with multiorgan system failure. Medical Management I/V fluids to stabilize blood pressure I/V antibodies to fight source of infection For GAS infection- clindamycin (600 mg -900 mg IV 8h) Or combined therapy, in which penicillin G (4 million U IV 8h) is combined with clindamycin. ref : ananthanaryana 9th ed