PMID- 1550711
OWN - NLM
STAT- MEDLINE
DCOM- 19920429
LR  - 20051116
IS  - 0278-145X (Print)
IS  - 0278-145X (Linking)
VI  - 11
IP  - 1
DP  - 1992 Mar
TI  - Staphylococcal toxin-mediated syndromes in childhood.
PG  - 11-8
AB  - Staphylococcal toxic shock syndrome (TSS) and staphylococcal scalded skin 
      syndrome (SSSS) are two distinct toxin-mediated syndromes with prominent 
      cutaneous features. The exanthematous presentation of these syndromes places them 
      in the broad category of childhood exanthems, and the ability to recognize these 
      potentially devastating illnesses is essential for pediatricians and 
      dermatologists who may encounter children with fever and rash. Recent advances in 
      the understanding of the pathogenesis of these entities has helped to explain the 
      distinctive clinical presentations of TSS and SSSS. Toxic shock syndrome toxin-1 
      (TSST-1) and enterotoxins are the secretory products of Staphylococcus aureus 
      that lead to TSS. Many of the clinical features of TSS (fever, shock, multiple 
      organ dysfunction) can be explained by the effects of cytokines (especially 
      interleukin-1 and tumor necrosis factor) induced by TSST-1. TSS is not an 
      exclusively menstrual event associated with tampon use. Nonmenstrual pediatric 
      TSS may be associated with a wide variety of staphylococcal infections. Infected 
      burn wounds in hospitalized children and bacterial tracheitis (in some cases 
      following influenza B infection) are relatively high-risk settings for pediatric 
      TSS. The epidermolytic toxins (A and B) directly produce subgranular 
      epidermolysis leading to SSSS. SSSS encompasses a clinical spectrum from bullous 
      impetigo to the widespread exfoliation of the Ritter disease variant of SSSS. 
      This entity usually occurs in children under 5 years of age, and is primarily 
      explained by lack of immunity to the toxins as well as renal immaturity leading 
      to poor clearance of toxin. The newborn nursery is an important setting where 
      epidemics of SSSS have occurred.(ABSTRACT TRUNCATED AT 250 WORDS)
FAU - Resnick, S D
AU  - Resnick SD
AD  - Department of Dermatology, University of North Carolina, School of Medicine, 
      Chapel Hill.
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Semin Dermatol
JT  - Seminars in dermatology
JID - 8211646
SB  - IM
MH  - Child
MH  - Diagnosis, Differential
MH  - Humans
MH  - *Shock, Septic/diagnosis/etiology/therapy
MH  - *Staphylococcal Infections/diagnosis/etiology/therapy
MH  - *Staphylococcal Scalded Skin Syndrome/diagnosis/etiology
RF  - 71
EDAT- 1992/03/01 00:00
MHDA- 1992/03/01 00:01
CRDT- 1992/03/01 00:00
PHST- 1992/03/01 00:00 [pubmed]
PHST- 1992/03/01 00:01 [medline]
PHST- 1992/03/01 00:00 [entrez]
PST - ppublish
SO  - Semin Dermatol. 1992 Mar;11(1):11-8.