Table 1. Staphylococcal toxic shock syndrome case definitions*.

Criteria	Definition
Clinical
Fever	Temperature >38.9°C (102.0°F)
Rash	Diffuse macular erythroderma
Desquamation	1–2 weeks after onset of illness, particularly on the palms and soles
Hypotension	Systolic blood pressure <90 mm Hg for adults or <5th percentile by age for children <16 years of age; orthostatic decrease in diastloc blood pressure >5 mm Hg from lying to sitting, orthostatic syncope, or orthostatic dizziness
Multisystem organ involvement†
Gastrointestinal	Vomiting or diarrhea at onset of illness
Muscular	Severe myalgia or creatine phosphokinase level at least twice the upper limit of normal
Mucous membrane	Vaginal, oropharyngeal, or conjunctival hyperemia
Renal	Blood urea nitrogen or creatinine at least twice the upper limit of normal for laboratory or urinary sediment with pyuria (>5 leukocytes by high-power field) in the absence of urinary tract infection
Hepatic	Total bilirubin, alanine aminotransferase, or aspartate aminotransferase levels at least twice the upper limit of normal
Hematologic	Platelet counts <100 × 109/L
Central nervous system	Disorientation or alterations in consciousness with focal neurologic signs when fever and hypotension are absent
Laboratory
Culture	If obtained, negative results on blood, throat, or cerebrospinal fluid cultures (blood culture may be positive for Staphylococcus aureus)
Titer	If obtained, no increase in titer for Rocky Mountain spotted fever, leptospirosis, or measles
Case classification
Probable	Meets laboratory criteria and in which 4 of 5 clinical findings described above are present
Confirmed	Meets laboratory criteria and in which all 5 of the clinical findings described above are present, including desquamation, unless the patient dies before desquamation occurs

*From the US Centers for Disease Control and Prevention (5).
†Involving >3 organ systems.