Document Detail

Skin Findings of Staphylococcus aureus Toxin-Mediated Infection in Relation to Toxin Encoding Genes.
MedLine Citation:
PMID:  23446443     Owner:  NLM     Status:  Publisher    
BACKGROUND:: Staphylococcal scalded skin syndrome and toxic shock syndrome are associated with exfoliatins and superantigens, respectively; and are easy to distinguish in their usual presentation. However, there is confusion about the mild forms of these two staphylococcal diseases. These mild forms are both designated as "staphylococcal scarlet fever" despite differences in their pathophysiology and clinical presentation.Our study aimed to distinguish between the clinical characteristics of the rash associated with exfoliatins and the rash associated with superantigens. METHODS:: Patients were selected from the French National Reference Center for Staphylococci. We retrospectively compared the clinical characteristics of patients with a generalized rash during S. aureus infection. Patients that met the criteria of staphylococcal scalded skin syndrome or toxic shock syndrome were excluded. The patients were classified into two groups, depending on the presence of a gene coding for exfoliatin or for superantigenic toxin. RESULTS:: We included 13 cases with exfoliatin and 9 with superantigens. The patients of the exfoliatin group were more likely to have facial involvement, fold involvement and a superficial focus of infection. In the second group, S. aureus was isolated from a deeper focus in 8/9 patients. CONCLUSION:: Mild forms of S. aureus toxin-mediated infection affect the paediatric population. Examination made it possible to distinguish an exanthema associated with an exfoliatin from one associated with a superantigen. This early clinical distinction results in differences in management.
Johan Courjon; Thomas Hubiche; Alice Phan; Anne Tristan; Michele Bès; François Vandenesch; Jerome Etienne; Pascal Del Giudice; Yves Gillet
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-2-26
Journal Detail:
Title:  The Pediatric infectious disease journal     Volume:  -     ISSN:  1532-0987     ISO Abbreviation:  Pediatr. Infect. Dis. J.     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-2-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8701858     Medline TA:  Pediatr Infect Dis J     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
1. Infectious Diseases Unit, hôpital de l'Archet 1, Centre Hospitalier Universitaire de Nice, BP 3079, 06202 Nice, France and Université Nice Sophia Antipolis, Nice, France 2. Dermatology and Infectious Diseases Unit, CHI Fréjus Saint Raphaël, 240 avenue de Saint Lambert, 83600 Fréjus, France 3. Pediatric Dermatology Unit, Hôpital Femme Mère Enfant, 59 boulevard Pinel 69677 Bron cedex, France 4. Centre National de Référence des Staphylocoques, INSERM U851, Université Lyon, 7 rue Guillaume Paradin, 9007 Lyon, France 5. Pediatric Emergency and Intensive Care Unit. Hôpital Femme Mère Enfant, 59 boulevard Pinel, 69677 Bron cedex, France.
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