A 15-year old boy was admitted to our Emergency Department with fever and confusion that started one day after having eaten meat in a fast food restaurant. He reported sweating, vomiting, myalgias and a cutaneous rash, whilst his mother noted that he was mildly confused. The patient had no medical history nor followed any treatment and had not traveled recently. On the initial physical examination his body temperature was 38.6  C, blood pressure 60/30 mmHg, heart rate 170 bpm, and oxygen saturation 98%. He had a diffuse cutaneous exanthema appearing mainly on the chest and upper limbs. The rest of the examination was normal, except for a moderate abdominal tenderness and mild confusion. Blood tests showed elevated inflammatory markers with 21 000 WBC/mm3 (92% neutrophils) and a CRP of 250 mg/L, coagulopathy, and acute renal failure. The patient was transferred to the Intensive Care Unit where he was stabilized with intravenous fluids and vasopressors; empirical amoxicillin-clavulanate was initiated. The following day, results of both admission blood cultures were positive for staphylococci. Rapid identification by Maldi-TOF MS (Bruker  Germany) with a 5-hour culture showed Staphylococcus aureus and a quick test of PBP2a (Alere ) was negative. A complete antibiogram confirmed the presence of a multi-sensitive bacterial strain. Follow-up blood cultures remained negative, stool culture was negative, and a trans-esophageal echocardiography was normal. Treatment with intravenous antibiotics was maintained for 7 days and the patient was discharged with oral antibiotics for one more week. Hand and feet desquamation was observed 2 weeks after disease onset. Molecular analysis by real-time PCR assay of the Staphylococcus aureus strain confirmed the presence of the tsst-1 gene and the absence of eta or etb toxins. Typing of the strain showed the presence of t2509 Staphylococcus aureus.