International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2026
Skin biopsy PCR enables rapid diagnosis of tattoo-associated staphylococcal toxic shock syndrome.
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Destoop Justin, Senoune Sonia, De-Waard Aurianne, Dubourg Grégory, Cassir Nadim
Аннотация
BACKGROUND: Staphylococcal toxic shock syndrome (TSS) is a rare but potentially fatal toxin-mediated disease. Early diagnosis is challenging because blood cultures are frequently negative and clinical manifestations may initially be nonspecific.
CASE PRESENTATION: A 29-year-old man presented with fever, diarrhoea, hypotension, and purpuric lesions localized to a calf tattoo performed three days earlier. Laboratory investigations revealed systemic inflammation, acute kidney injury, thrombocytopenia, and hepatic dysfunction. Despite negative blood cultures and cerebrospinal fluid analyses, the subsequent development of a diffuse rash raised suspicion of staphylococcal TSS. Real-time PCR performed on a skin biopsy obtained from the tattoo lesion detected Staphylococcus aureus and the toxic shock syndrome toxin-1 (TSST-1) gene, confirming the diagnosis. The patient received clindamycin combined with β-lactam therapy and experienced rapid clinical improvement, followed by characteristic desquamation.
CONCLUSIONS: This case highlights the diagnostic value of PCR testing performed on skin biopsy specimens for rapid microbiological confirmation of tattoo-associated staphylococcal TSS.
CASE PRESENTATION: A 29-year-old man presented with fever, diarrhoea, hypotension, and purpuric lesions localized to a calf tattoo performed three days earlier. Laboratory investigations revealed systemic inflammation, acute kidney injury, thrombocytopenia, and hepatic dysfunction. Despite negative blood cultures and cerebrospinal fluid analyses, the subsequent development of a diffuse rash raised suspicion of staphylococcal TSS. Real-time PCR performed on a skin biopsy obtained from the tattoo lesion detected Staphylococcus aureus and the toxic shock syndrome toxin-1 (TSST-1) gene, confirming the diagnosis. The patient received clindamycin combined with β-lactam therapy and experienced rapid clinical improvement, followed by characteristic desquamation.
CONCLUSIONS: This case highlights the diagnostic value of PCR testing performed on skin biopsy specimens for rapid microbiological confirmation of tattoo-associated staphylococcal TSS.