Staphylococcal scalded skin syndrome in adults: A clinical review illustrated with a new case

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Abstract

Staphylococcal scalded skin syndrome is rarely observed in adults; only 32 cases have been reported. In contrast to infant cases, the mortality rate is high. Two major risk factors have been identified: kidney failure and immunosuppression. In adults, clinical features are similar to those of the typical pediatric disease, but blood cultures are often positive for Staphylococcus aureus. Detection of the exfoliative toxin is required for diagnosis; the newborn mouse bioassay is, therefore, usually performed. New immunologic methods allow precise characterization of the toxins and oligonucleotide probes can be used for rapid detection of toxigenic strains. We report a case of staphylococcal scalded skin syndrome in an immunocompetent adult in whom blood cultures were positive; this is the first case in which both exfoliative toxins A and B have been identified in an adult.

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      Citation Excerpt :

      Careful fluid balance management is required and meticulous wound care is needed to prevent superinfection which is a common complication of AGPP [4]. Interestingly, Staphylococcal scalded skin syndrome is rare in adults although in the setting of immunosuppression it should also be part of the possible diagnoses [9]. A case describing SSSS complicating AGPP has also been previously described [10].

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    a

    From the Clinique Dermatologique, Hôpitaux Universitaires de Strasbourg.

    b

    the Laboratoire de Bactériologie, Faculté de Médecine.

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