The case of a 18-year-old woman with the toxic shock syndrome (TSS) associated to a staphylococcal infection in the maxillary sinus is presented. The initial course of the disease was clinically superposed to a Kawasaki syndrome (KS). Both entities, of purely clinical diagnosis, possess many common elements occasionally making differentiation extremely difficult. The clinical data that may orient diagnosis to one of the processes was analyzed. Finally, it is emphasized that the paranasal sinus must be considered as an occult foci in those cases of TSS in which there is no apparent foci of infection.