A 16 year old girl in previously good health became ill 2 days ago with fever to 102.2 F, myalgias, abdominal pain, and profuse vomiting and diarrhea. Yesterday she noticed a sunburn-like rash that covered her entire body but was most intense on her inner thighs and her palms and soles. This morning she was unable to get out of bed due to feeling "too sick", and when she was helped to stand, she nearly fainted from "light-headedness". She is having her menstrual period and was wearing a tampon. Physical Exam: T 98.6, P 160, RR 30, BP 60/40 supine.
She is an ill-appearing adolescent female who is poorly oriented to her surroundings and only responds to questions with much coaxing, and her answers are incoherent. Her conjunctivae are injected. She has oral mucosal hyperemia and hypertrophy of her tongue papillae. Tonsils are not enlarged. Total body erythroderma is noted, most…
