{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T08:24:33Z","timestamp":1787732673813,"version":"build-2784847793"},"reference-count":17,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int J Emerg Med"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Toxic shock syndrome (TSS) is a rare but life-threatening complication occasionally reported after tattooing.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Case presentation<\/jats:title>\n            <jats:p>: A 29-year-old Japanese man was admitted to Okayama University Hospital, Okayama, Japan, in early spring 2025, one week after receiving a tattoo on his right shoulder and upper arm in Osaka. He presented with fever, gastrointestinal symptoms, hypotension, and multi-organ failure. Despite a failure to isolate a causative pathogen, he met clinical criteria for TSS. Supportive care and broad-spectrum antibiotics led to full recovery.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>TSS can occur after tattooing, even in individuals without apparent immunodeficiency. Pathogenic organisms may be unidentifiable; however, clinical diagnosis should not be delayed, and early therapeutic interventions are essential to improve outcomes.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s12245-025-00993-2","type":"journal-article","created":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T10:17:55Z","timestamp":1759313875000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Tattoo-associated toxic shock syndrome: a case report"],"prefix":"10.1186","volume":"18","author":[{"given":"Takuya","family":"Kubo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuya","family":"Yumoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hideharu","family":"Hagiya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koji","family":"Iio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiromichi","family":"Naito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsunori","family":"Nakao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,10,1]]},"reference":[{"issue":"6","key":"993_CR1","doi-asserted-by":"publisher","first-page":"807","DOI":"10.1016\/j.jemermed.2017.12.048","volume":"54","author":"M Gottlieb","year":"2018","unstructured":"Gottlieb M, Long B, Koyfman A. The evaluation and management of toxic shock syndrome in the emergency department: a review of the literature. J Emerg Med. 2018;54(6):807\u201314.","journal-title":"J Emerg Med"},{"issue":"1","key":"993_CR2","doi-asserted-by":"publisher","DOI":"10.3390\/antibiotics13010096","volume":"13","author":"E Atchade","year":"2024","unstructured":"Atchade E, De Tymowski C, Grall N, Tanaka S, Montravers P. Toxic shock syndrome: a literature review. Antibiotics. 2024;13(1):96.","journal-title":"Antibiotics"},{"issue":"8","key":"993_CR3","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0022997","volume":"6","author":"AS DeVries","year":"2011","unstructured":"DeVries AS, Lesher L, Schlievert PM, Rogers T, Villaume LG, Danila R, et al. Staphylococcal toxic shock syndrome 2000\u20132006: epidemiology, clinical features, and molecular characteristics. PLoS One. 2011;6(8):e22997.","journal-title":"PLoS One"},{"issue":"4","key":"993_CR4","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1016\/j.medcli.2021.01.014","volume":"158","author":"J Rello","year":"2022","unstructured":"Rello J, Tejada S, Campogiani L, Adebanjo AG, Tammaro A. Systemic infections associated with tattoos or permanent makeup: A systematic review. Med Clin (Barc). 2022;158(4):159\u201366.","journal-title":"Med Clin (Barc)"},{"issue":"1","key":"993_CR5","first-page":"5","volume":"72","author":"DU Elegino-Steffens","year":"2013","unstructured":"Elegino-Steffens DU, Layman C, Bacomo F, Hsue G. A case of severe septicemia following traditional Samoan Tattooing. Hawaii J Med Public Health. 2013;72(1):5\u20139.","journal-title":"Hawaii J Med Public Health"},{"issue":"3","key":"993_CR6","doi-asserted-by":"publisher","first-page":"184","DOI":"10.4266\/kjccm.2015.30.3.184","volume":"30","author":"KY Jeong","year":"2015","unstructured":"Jeong KY, Kim KS, Suh GJ, Kwon WY. Toxic shock syndrome following tattooing. Korean J Crit Care Med. 2015;30(3):184\u201390.","journal-title":"Korean J Crit Care Med"},{"issue":"3","key":"993_CR7","first-page":"e14139","volume":"13","author":"S Uggeri","year":"2021","unstructured":"Uggeri S, Nasi F, Ghidoni M, Gilioli F, Guicciardi N. Legal tattoo complicated by sepsis and necrotizing fasciitis requiring acute surgery. Cureus. 2021;13(3):e14139.","journal-title":"Cureus"},{"issue":"10016","key":"993_CR8","doi-asserted-by":"publisher","first-page":"395","DOI":"10.1016\/S0140-6736(15)60215-X","volume":"387","author":"P Laux","year":"2016","unstructured":"Laux P, Tralau T, Tentschert J, Blume A, Dahouk S, Al, B\u00e4umler W, et al. A medical-toxicological view of Tattooing. Lancet. 2016;387(10016):395\u2013402.","journal-title":"Lancet"},{"issue":"6","key":"993_CR9","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1093\/cid\/cit347","volume":"57","author":"RR Falsey","year":"2013","unstructured":"Falsey RR, Kinzer MH, Hurst S, Kalus A, Pottinger PS, Duchin JS, et al. Cutaneous inoculation of nontuberculous mycobacteria during professional tattooing: A case series and epidemiologic study. Clin Infect Dis. 2013;57(6):143\u20137.","journal-title":"Clin Infect Dis"},{"key":"993_CR10","unstructured":"Centers for Disease Control and Prevention. Toxic shock syndrome (other than streptococcal) (TSS) 2011 case definition. https:\/\/ndc.services.cdc.gov\/case-definitions\/toxic-shock-syndrome-2011\/ Accessed 5 May 2025."},{"issue":"1","key":"993_CR11","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-023-08487-3","volume":"23","author":"C Armeftis","year":"2023","unstructured":"Armeftis C, Ioannou A, Lazarou T, Giannopoulos A, Dimitriadou E, Makrides K, et al. Staphylococcus epidermidis induced toxic shock syndrome (TSS) secondary to influenza infection. BMC Infect Dis. 2023;23(1):583.","journal-title":"BMC Infect Dis"},{"issue":"5","key":"993_CR12","doi-asserted-by":"publisher","DOI":"10.3390\/ijms20051215","volume":"20","author":"X Argemi","year":"2019","unstructured":"Argemi X, Hansmann Y, Prola K, Pr\u00e9vost G. Coagulase-negative staphylococci pathogenomics. Int J Mol Sci. 2019;20(5):1215.","journal-title":"Int J Mol Sci"},{"issue":"1","key":"993_CR13","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1186\/s12879-020-05731-y","volume":"21","author":"K Goda","year":"2021","unstructured":"Goda K, Kenzaka T, Hoshijima M, Yachie A, Akita H. Toxic shock syndrome with a cytokine storm caused by Staphylococcus simulans: a case report. BMC Infect Dis. 2021;21(1):19.","journal-title":"BMC Infect Dis"},{"key":"993_CR14","doi-asserted-by":"publisher","first-page":"S147","DOI":"10.1016\/S0163-4453(17)30206-2","volume":"74","author":"AL Wilkins","year":"2017","unstructured":"Wilkins AL, Steer AC, Smeesters PR, Curtis N. Toxic shock syndrome \u2013 the seven Rs of management and treatment. J Infect. 2017;74:S147\u201352.","journal-title":"J Infect"},{"issue":"1","key":"993_CR15","doi-asserted-by":"publisher","DOI":"10.1186\/s40560-025-00776-0","volume":"13","author":"N Shime","year":"2025","unstructured":"Shime N, Nakada TA, Yatabe T, Yamakawa K, Aoki Y, Inoue S, et al. The Japanese clinical practice guidelines for management of sepsis and septic shock 2024. J Intensive Care. 2025;13(1):15.","journal-title":"J Intensive Care"},{"issue":"9","key":"993_CR16","doi-asserted-by":"publisher","first-page":"1434","DOI":"10.1093\/cid\/ciy401","volume":"67","author":"T Parks","year":"2018","unstructured":"Parks T, Wilson C, Curtis N, Norrby-Teglund A, Sriskandan S. Polyspecific intravenous immunoglobulin in clindamycin-treated patients with Streptococcal toxic shock syndrome: a systematic review and meta-analysis. Clin Infect Dis. 2018;67(9):1434\u20136.","journal-title":"Clin Infect Dis"},{"issue":"7","key":"993_CR17","doi-asserted-by":"publisher","first-page":"877","DOI":"10.1093\/cid\/ciw871","volume":"64","author":"SS Kadri","year":"2017","unstructured":"Kadri SS, Swihart BJ, Bonne SL, Hohmann SF, Hennessy LV, Louras P, et al. Impact of intravenous immunoglobulin on survival in necrotizing fasciitis with vasopressor-dependent shock: a propensity score-matched analysis from 130 US hospitals. Clin Infect Dis. 2017;64(7):877\u201385.","journal-title":"Clin Infect Dis"}],"container-title":["International Journal of Emergency Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12245-025-00993-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12245-025-00993-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12245-025-00993-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T10:17:57Z","timestamp":1759313877000},"score":1,"resource":{"primary":{"URL":"https:\/\/intjem.biomedcentral.com\/articles\/10.1186\/s12245-025-00993-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,1]]},"references-count":17,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["993"],"URL":"https:\/\/doi.org\/10.1186\/s12245-025-00993-2","relation":{},"ISSN":["1865-1380"],"issn-type":[{"value":"1865-1380","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,1]]},"assertion":[{"value":"5 May 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 August 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 October 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"<!--Emphasis Type='Bold' removed-->Ethics approval and consent to participate."}},{"value":"Written informed consent was obtained from the patient for the publication of this case report and the accompanying images.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"<!--Emphasis Type='Bold' removed-->Consent for publication."}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"185"}}