A 29-year-old man arrived at an emergency department with two days of fever and diarrhea. His blood pressure was 89/54 mmHg, his heart rate was 130 beats per minute, and his temperature was 39.1°C, about 102.4°F. Doctors spotted one telling detail: purple, bruise-like spots clustered around a tattoo on his calf that had been done three days earlier.
Blood cultures and spinal fluid tests came back negative. Instead, a molecular test on a small piece of skin from the tattoo detected Staphylococcus aureus and the gene for toxic shock syndrome toxin-1, or TSST-1. That confirmed staphylococcal toxic shock syndrome, a rare, toxin-driven illness that can damage multiple organs and can be fatal. The discoloration around his tattoo was purpura, caused by tiny areas of bleeding under the skin.
