TSS is most characteristically seen in females using vaginal tampons and is secondary to staphylococcal enterotoxins called TSS toxin 1 (TSST-1). Abrupt onset is characteristic. The clinical criteria for diagnosis include high fever, a diffuse rash that desquamates on the palms and soles over the subsequent 1-2 weeks, hypotension, and involvement in 3 or more organ systems. This involvement can include GI dysfunction (vomiting and diarrhea), renal insufficiency, hepatic insufficiency, thrombocytopenia, myalgias with elevated creatine kinase (CK) levels, and delirium Staphylococcal-scaled-skin syndrome most often affects new-born and children. It results in localized or quite extensive fluid-filled blisters that easily rupture to expose denuded skin. It is caused by an exfoliative toxin.