Staphylococcal scalded skin syndrome and toxic shock syndrome after tooth extraction.
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.
Brewer
Jerry D
JD
Department of Dermatology, Mayo Clinic, Rochester, Minnesota 55905, USA.
Hundley
Michelle D
MD
Meves
Alexander
A
Hargreaves
James
J
McEvoy
Marian T
MT
Pittelkow
Mark R
MR
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