title: Staphylococcal scalded skin syndrome and toxic shock syndrome after tooth extraction.
abstract: Staphylococcus aureus may cause cutaneous and systemic infections such as staphylococcal scalded skin syndrome (SSSS) and toxic shock syndrome (TSS). Although exfoliative toxins A and B, which cause SSSS, and TSS toxin-1 may be produced by different strains of S aureus, the two syndromes rarely occur simultaneously. We describe a patient admitted to the intensive care department with an exfoliative generalized erythroderma, signs of shock, and biopsy specimen findings consistent with SSSS. This patient presented after a tooth extraction. Symptoms recurred after dismissal, and he was readmitted. Subsequent test results were positive for exfoliative toxin B and TSS toxin-1, suggesting concurrent SSSS and TSS. For patients with acute, exfoliative, generalized erythroderma, TSS and SSSS should be considered. Although rare, it is possible to see both syndromes present concurrently.
authors.affiliation: Department of Dermatology, Mayo Clinic, Rochester, Minnesota 55905, USA.
authors.forename: Jerry D
authors.initials: JD
authors.lastname: Brewer
authors.forename: Michelle D
authors.initials: MD
authors.lastname: Hundley
authors.forename: Alexander
authors.initials: A
authors.lastname: Meves
authors.forename: James
authors.initials: J
authors.lastname: Hargreaves
authors.forename: Marian T
authors.initials: MT
authors.lastname: McEvoy
authors.forename: Mark R
authors.initials: MR
authors.lastname: Pittelkow
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D004638:Emergency Treatment; D006801:Humans; D008297:Male; D011183:Postoperative Complications; D012772:Shock, Septic / Q000150:complications / Q000175:diagnosis* / Q000382:microbiology / Q000628:therapy; D013206:Staphylococcal Scalded Skin Syndrome / Q000150:complications / Q000175:diagnosis* / Q000382:microbiology / Q000628:therapy; D013211:Staphylococcus aureus / Q000145:classification / Q000302:isolation & purification; D014081:Tooth Extraction