An unusual case of menstrual toxic shock syndrome (TSS) is described in which the patient had persistent Staphylococcus aureus bacteremia despite therapy with iv cloxacillin. There was no demonstrable evidence of endocarditis or an abscess as a focus for persisting bacteremia. The strain of S. aureus isolated from the blood and vagina produced toxic shock syndrome toxin 1 (TSST-1) and enterotoxin A. Bacteremia occurs uncommonly in association with TSS; however, aggressive high-dose antistaphylococcal therapy should be instituted for treating this possible complication. The diagnosis of toxic shock syndrome (TSS) is based upon well-described clinical and laboratory criteria [ 1]. Al-though bacteremia is an uncommon finding in association with menstrual TSS, we report a case complicated by persis-tent bacteremia in spite of high-dose, iv antibiotic treatment. A 19-year-old previously healthy woman who was febrile and in shock was transferred to University Hospital. Her menstrual period had begun 10 days earlier, and she ha
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