Question category: Tropical medicine
An 18 year old female is brought to A and E very unwell with a high fever, a macular and erythrodermic rash, myalgia and diarrhoea and vomiting. She is hypotensive. She is thought to have a tampon retained. She is transferred to ITU as she is found to be in Acute renal, liver and respiratory failure. 10 days after the onset there was desquamation of the palms and soles. What is the most likely diagnosis?