Erythema multiforme (EM) and staphylococcal toxic shock syndrome (TSS) are acute, potentially life-threatening conditions that may present with overlapping clinical manifestations. EM typically features targetoid skin lesions, whereas TSS is characterized by fever, hypotension, and diffuse erythroderma with systemic involvement. We report the case of a 34-year-old man with end-stage renal disease (ESRD) undergoing routine hemodialysis, who developed generalized erythematous and pruritic lesions, fever, nausea, vomiting, and abdominal pain after receiving antibiotic therapy for pilonidal cyst surgery. His presentation suggested a possible overlap between EM and TSS. Prompt empiric treatment with corticosteroids, antihistamines, intravenous fluids, and antibiotic adjustment led to clinical improvement. This case highlights the diagnostic challenges of differentiating between EM and TSS in patients with complex comorbidities and underscores the importance of early recognition, supportive care, and vigilance regarding adverse drug reactions.
Soleymani et al. (Thu,) studied this question.