title: Cluster of Staphylococcus aureus and dengue co-infection in Singapore.
abstract: BACKGROUND
  Singapore saw a resurgence of dengue infections in 2005. Concurrent bacterial co-infections in dengue is rare.
  
  
  METHODS
  We report a cluster of serious methicillin-susceptible Staphylococcus aureus (MSSA) bacteraemia or severe soft tissue infection in 5 epidemiologically linked construction workers presenting with dengue and non-resolving fever.
  
  
  METHODS
  Surgical intervention was indicated in 4 of the 5 patients despite appropriate antistaphylococcal therapy.
  
  
  RESULTS
  All but 1 patient were eventually discharged. Clonality and Panton-Valentine leucocidin genes were not demonstrated. Epidemiological investigations suggested that occupational contact dermatitis could have predisposed the patients to this opportunistic co-infection.
  
  
  CONCLUSIONS
  Clinicians need to be vigilant to unusual manifestations of dengue which may signal a concomitant aetiology.
authors.affiliation: Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore.
authors.forename: Louis Y A
authors.initials: LY
authors.lastname: Chai
authors.forename: Poh-Lian
authors.initials: PL
authors.lastname: Lim
authors.forename: Cheng-Chuan
authors.initials: CC
authors.lastname: Lee
authors.forename: Li-Yang
authors.initials: LY
authors.lastname: Hsu
authors.forename: Yee-Leong
authors.initials: YL
authors.lastname: Teoh
authors.forename: David C B
authors.initials: DC
authors.lastname: Lye
authors.forename: Prabha
authors.initials: P
authors.lastname: Krishnan
authors.forename: Yee-Sin
authors.initials: YS
authors.lastname: Leo
mesh_terms: D000328:Adult; D016000:Cluster Analysis; D003715:Dengue / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D008297:Male; D008712:Methicillin / Q000494:pharmacology; D009790:Occupations; D012846:Singapore / Q000453:epidemiology; D018461:Soft Tissue Infections / Q000635:transmission; D013203:Staphylococcal Infections / Q000150:complications* / Q000453:epidemiology / Q000628:therapy / Q000635:transmission; D013207:Staphylococcal Skin Infections / Q000635:transmission; D013211:Staphylococcus aureus / Q000187:drug effects
chemical_list: D008712:Methicillin