title: Staphylococcus aureus bacteremia complicating herpes simplex virus type 1 stomatitis: case report and review of the literature.
abstract: BACKGROUND
  Gingivostomatitis is a common clinical manifestation of primary herpes simplex virus type 1 (HSV-1) infection in children. The most common complication of herpetic gingivostomatitis is dehydration; rarely, it may be complicated by secondary bacteremia, and Kingella kingae and group A Streptococcus infections have been reported to be responsible for such episodes.
  
  
  METHODS
  We describe the clinical course of a 4.5-year-old girl several years after a liver transplantation, who presented with high fever, vesicular lesions in the buccal region, and cervical lymphadenopathy.
  
  
  RESULTS
  Viral culture from the vesicles grew HSV-1, whereas blood culture and bacterial culture from the vesicles grew methicillin-sensitive Staphylococcus aureus with identical antibiogram. Serology against HSV-1 confirmed a recent infection. The child was treated with cephalexin and improved gradually.
  
  
  CONCLUSIONS
  Herpetic lesions of the oral mucosa might serve as a port of entry for pathogens including Staphylococcus aureus. Pediatricians and dentists should be aware of bacterial complications in children with herpetic stomatitis.
authors.affiliation: Department of Pediatrics C, Schneider Children's Medical Center of Israel, Petah Tiqva, Israel. dror_sho@netvision.net.il
authors.forename: Dror S
authors.initials: DS
authors.lastname: Shouval
authors.forename: Efraim
authors.initials: E
authors.lastname: Bilavsky
authors.forename: Yaron
authors.initials: Y
authors.lastname: Avitzur
authors.forename: Rivka
authors.initials: R
authors.lastname: Shapiro
authors.forename: Jacob
authors.initials: J
authors.lastname: Amir
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000209:etiology* / Q000382:microbiology; D002506:Cephalexin / Q000627:therapeutic use; D002675:Child, Preschool; D005260:Female; D018259:Herpesvirus 1, Human; D006801:Humans; D016867:Immunocompromised Host; D016031:Liver Transplantation; D013211:Staphylococcus aureus; D013283:Stomatitis, Herpetic / Q000150:complications* / Q000188:drug therapy / Q000821:virology
chemical_list: D000900:Anti-Bacterial Agents; D002506:Cephalexin