Toxic shock syndrome caused by hospital-acquired methicillin-resistant Staphylococcus aureus in a patient with pancytopenia

Toxic shock syndrome is an uncommon condition in patients with neutropenia. We describe a 44-year-old man who developed toxic shock syndrome caused by hospital acquired methicillin-resistant Staphylococcus aureus while pancytopenic after chemotherapy. He died of multiorgan failure despite high-level intensive care support and treatment with appropriate antibiotics and intravenous immunoglobulin. This case illustrates the need for a high index of suspicion for toxic shock syndrome in patients with febrile neutropenia, and also highlights the lack of high quality evidence for the various treatment modalities used in this syndrome.