Exfoliative dermatitis in an infant. Association with enterotoxin F-producing staphylococci.
A 2-month-old premature infant had an extensive exfoliative dermatitis with flaccid bullae, mucous membrane involvement, thrombocytopenia, and an elevated creatinine kinase level. A subepidermal cleavage plane with numerous necrotic epidermal cells and a polymorphonuclear cell infiltrate were present on a skin biopsy specimen. The isolates of Staphylococcus aureus obtained at the onset of her disease had a 29/52 bacteriophage lysis pattern and produced enterotoxins C and F and epidermal toxin, but no exfolliatins. In toxic shock syndrome (TSS), subepidermal blister formation has been described and a new toxin, epidermal toxin, which causes subepidermal cleavage in the newborn mouse model, has been identified. In some infants, exfoliative dermatitis may be a variant of the well-described TSS in older children and adults.
D001427:Bacterial Toxins; D001434:Bacteriophage Typing; D001706:Biopsy; D003402:Creatine Kinase / Q000097:blood; D003873:Dermatitis, Exfoliative / Q000209:etiology* / Q000473:pathology; D004768:Enterotoxins / Q000096:biosynthesis*; D004817:Epidermis / Q000473:pathology; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000209:etiology*; D007440:Intubation / Q000009:adverse effects; D013203:Staphylococcal Infections / Q000209:etiology*; D013211:Staphylococcus aureus / Q000302:isolation & purification; D018089:Superantigens
D001427:Bacterial Toxins; D004768:Enterotoxins; D018089:Superantigens; C030107:enterotoxin F, Staphylococcal; C034959:enterotoxin C, staphylococcal; D003402:Creatine Kinase