Which sign is characteristic of toxic shock syndrome?

Toxic shock syndrome (TSS) is a severe condition often caused by toxins produced by certain strains of bacteria, notably Staphylococcus aureus and Streptococcus pyogenes. The key signs of TSS typically include hypotension, which results from vascular instability, and generalized erythema or a diffuse rash that can resemble sunburn. This widespread erythema is often accompanied by desquamation, particularly of the palms and soles, after the initial presentation.

Hypotension is a critical feature because it signifies significant systemic involvement and possible shock, which can be life-threatening. The combination of these symptoms helps in the identification of TSS, allowing for prompt intervention and treatment. In contrast to the other options presented, hypotension with generalized erythema specifically aligns with the pathophysiology of TSS, highlighting the multi-organ impact and vascular dysregulation that occurs during this syndrome.