Summary Staphylococcal scalded skin syndrome (SSSS) is typically a clinical diagnosis,1 affecting primarily neonates and children. It is characterised by a diffuse skin disorder with tenderness, erythema, large wrinkled superficial blistering, and desquamation caused by the hematogenous dissemination of exotoxin-producing strains of staphylococcus aureus to the skin.4,10 Hospital admission is required for intravenous anti-staphylococcal antibiotic therapy and supportive care. The rarity of SSSS in adults is best explained by the presence of exotoxins neutralizing antibodies and renal elimination of the toxins.2 Two major risk factors are kidney failure and immunosuppression. Therefore, SSSS in adults warrants thorough evaluation.3 Mortality is also greater than 60% in adults, attributed to predisposing comorbid conditions.1,4 One of the mimickers of SSSS is toxic epidermal necrolysis (TEN). Here, we report a successful treatment of SSSS in an adult with recreational drug abuse and incidental liver cirrhosis possibly secondary to hepatitis C viral infection, after careful exclusion of TEN.
Staphylococcal Scalded Skin Syndrome ; Staphylococcal Infections ; Adult

The Job's syndrome is a relatively rare primary immunodeficiency disorder characterized by recurrent staphylococcal infection and abscess formation, defective neutrophil chemotaxis, and markedly elevated serum IgE level. Clinical features are atopiclike dermatitis, furunculosis, paronychia, pulmonary bacterial pneumonia etc. We reported a case of Job's syndrome in a 12-year-old girl who had recurrent pneumonia, scaly pruritic dermatitis, fissured tongue, and nail dystrophy with elevated serum IgE level.
Abscess ; Chemotaxis ; Child ; Dermatitis ; Female ; Furunculosis ; Humans ; Immunoglobulin E ; Job Syndrome* ; Neutrophils ; Paronychia ; Pneumonia ; Pneumonia, Bacterial ; Staphylococcal Infections ; Tongue, Fissured

Staphylococcal scalded skin syndrome (SSSS) is an exfoliative infectious disorder caused by the exfoliative toxins of Staphylococcus aureus. The condition usually affects infants and children younger than 5 years of age. However, SSSS is rarely observed in adults. Adult SSSS is usually associated with renal failure, immunosuppression, malignancy, alcohol abuse, or HIV infection. In contrast to infant cases, adult SSSS is often accompanied with a high mortality rate, sepsis and poor prognosis. We report a rare case of SSSS in an immunocompetent 34-year-old man without renal failure.
Adult ; Alcoholism ; Child ; Exfoliatins ; HIV Infections ; Humans ; Immunosuppression ; Infant ; Prognosis ; Renal Insufficiency ; Sepsis ; Staphylococcal Scalded Skin Syndrome ; Staphylococcus aureus

The hyperimmunoglobulin E syndrome is a primary immunodificiency disorder characterized by recurrent staphylococcal infections and markedly elevated serum IgE level. Clinical features are coarse face and severe infections of the skin-furunculosis or chronically pruritic dermatitis and sinopulmonary tract infection from infancy by coagulase positive Staphylococcus aureus, or Candida albicans etc. The patients's serum IgE level is elevated but the basic immunologic pathogenesis not fully understood. We have experienced a case of hyperimmunoglobulin E syndrome in a 26/12-year-old who had suffered from recurrent staphylococcal pneumonias and abscesses and chronically pruritic dermatitis from 1 month of age with elevated serum IgE level. A brief review of the related literature is presented.
Abscess ; Candida albicans ; Coagulase ; Dermatitis ; Immunoglobulin E ; Pneumonia, Staphylococcal ; Staphylococcal Infections ; Staphylococcus aureus

Community associated methicillin-resistant Staphylococcus aureus (CA-MRSA) subtype USA300 remains relatively well confined within North American shores. Between August and November 2010, a large international school in Singapore recorded 27 skin and soft tissue infections, 8 of which were confirmed USA 300. This study reports the outbreak investigation and the interventions instituted.
Community-Acquired Infections ; Disease Outbreaks ; Humans ; Methicillin ; Methicillin-Resistant Staphylococcus aureus ; Singapore ; Staphylococcal Infections ; epidemiology ; Staphylococcal Skin Infections

Bacteriological study, including antibiotic sensitivity tests, of 81 patients with pyodermas such as impetigo, folliculitis, furuncle, carbuncle, cellulitis and acuete infectious eczematoid dermatitis, was carried out during 4 months period from June, 1980 to September, 1980 at the department of dermatology, Han Il Hospital. The results were as follows: 1) The causative agents of impetigo in 42 patients, were coagulase positive Staphylacoccus aureus in 33, p-hemolytic Streptococcus in 6 and both organisms in R (S. aureus and 3-hemolytic Streptococcus). Coagulase negative Stgaphylococcus was not found. 2) The causative agents of superficial and deep follicultis in 23 cases, were coagulase positive S. aureus in 12, coaulase negative Staphylococcus in 5, p-hemolytic Streptococcus in 4 and S. aureus and p-hemolytic Streptococcus in 3. 3) The causative agents of cellulitis in 2 cases, were coagulase positive S. aureus in 1, and coagulase negative Staphylococcus in 1. 4) The causative agents of acute infectious eczematoid dermatitis in l4 cases, were coagulase positive S. aureus in 6, coagulase negative Staphylococcua in 1, p-hemolytic Streptococcus in 2, and two organisms in 5 (4 cases were mixed).
Carbuncle ; Cellulitis ; Coagulase ; Dermatitis ; Dermatology ; Folliculitis ; Furunculosis ; Humans ; Impetigo ; Pyoderma* ; Staphylococcus ; Streptococcus

Panton-Valentine leukocidin (PVL)-positive USA300 clone has been the most successful community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) clone spreading in North America. In contrast, PVL-negative ST72-CA-MRSA has been predominant in Korea, and there has been no report of infections by the USA300 strain except only one case report of perianal infection. Here, we describe the first case of pneumonia caused by the USA300 strain following pandemic influenza A (H1N1) in Korea. A 50-year-old man was admitted with fever and cough and chest radiograph showed pneumonic consolidation at the right lower lung zone. He received a ventilator support because of respiratory failure. PCR for pandemic influenza A (H1N1) in nasopharyngeal swab was positive, and culture of sputum and endotracheal aspirate grew MRSA. Typing of the isolate revealed that it was PVL-positive, ST 8-MRSA-SCCmec type IV. The analysis of the PFGE patterns showed that this isolate was the same pulsotype as the USA300 strain.
Community-Acquired Infections/*etiology/microbiology ; Humans ; Influenza A Virus, H1N1 Subtype ; Influenza, Human/*complications ; Male ; *Methicillin-Resistant Staphylococcus aureus/classification/isolation & purification ; Middle Aged ; Pneumonia, Staphylococcal/*etiology/microbiology ; Republic of Korea ; Staphylococcal Infections/*etiology/microbiology

Job's syndrome is an inflammatory skin disease characterized by (1) severe eczema, (2) recurrent staphylococcal infections of the skin and sinopulmonary tract, (3) cold subcutaneous abscesses, and (4) high serum IgE levels. We describe a 55-year-old woman with long-standing atopic dermatitis-like eczema, recurrent abscesses, and a high level of serum IgE. We suspected this case as Job's syndrome.
Abscess ; Eczema ; Female ; Humans ; Immunoglobulin E ; Job Syndrome* ; Middle Aged ; Skin ; Skin Diseases ; Staphylococcal Infections

BACKGROUND: Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infection is an emerging health problem in pediatrics. Risk factors are not well established in children.
OBJECTIVE: To determine the risk factors for the development of methicillin-resistant Staphylococcus aureus infections arising in the community.
METHODOLOGY: A restrospective case-control study was performed from January 2004 to December 2011. Cases included patients who were culture positive for Staphylococcus aureus and resistant to methicillin/oxacillin while Control included patients who were sensitive to methicillin/oxacillin. The study identified and analyzed the epidemiology, risk factors and resistance pattern of CA-MRSA isolates.
RESULTS: Three hundred twety three (323) patients with Staphylococcus aureus infections were enrolled: 172 were CA-MRSA infections (cases); and 151 were community acquired methicillin-sensitive Staphylococcus aureus (CA-MSSA) infections (control). Demographic characteristics and clinical profile were skin (cellulitis, furunculosis and abscess) and pulmonary (pneumonica and empyema). The survival rate was high for both groups (>90%). The final multivariate logistic regresion model showed that level of crowding and socio-economic status remained model showed that level of crowding and socio-economic status remained as risk factors for CA-MRSA. The odds of having CA-MRSA in crowded households is 0.35 (90%CI 0.20-0.62) less likely when compared to the odds of acquiring MRSA in less crowded households (p=0.003). Those who had low socio-eonomic had 2.49 times higher chance (90%CI; 1.39 -4.47) of aquiring CA-MRSA compared to those with higher socio-economic status (p=0.01).
CONCLUSION: CA-MRSA is an emerging problem. This warrants recognition of patients with significant risk factors such as low socio-economic status and level of crowding. This may serve guide in choosing the appropriate antimicrobial theraply.

Human ; Male ; Female ; Adolescent ; Child ; Child Preschool ; Infant ; Methicillin ; Methicillin-resistant Staphylococcus Aureus ; Oxacillin ; Furunculosis ; Anti-infective Agents ; Staphylococcal Infections ; Community-acquired Infections

PURPOSE: Staphylococcus aureus is a major cause of skin and soft tissue infections (SSTIs). This study aimed to determine the temporal trends in antibiotic susceptibility of S. aureus in SSTI patients aged <19 years.METHODS: This retrospective observational study was conducted in pediatric patients with SSTI caused by community-associated S. aureus. Microbiologic and demographic data were collected, and the trends of antibiotic susceptibility results were evaluated.RESULTS: From January 2010 to December 2018, a total of 807 S. aureus isolates were included. An overall increase in susceptibility of isolates to oxacillin was noted (P<0.001), with 75.0% of isolates being oxacillin-susceptible in 2018. S. aureus remained highly susceptible to trimethoprim/sulfamethoxazole and tetracycline, with 97.6% and 95.2% isolate susceptibility in 2018, respectively. Isolates from younger children aged 1 to 5 years had a significantly lower rate of susceptibility to oxacillin than older children aged 6 to 18 years (53.4% vs. 75.0%, P<0.001).CONCLUSIONS: The proportion of methicillin-resistant S. aureus isolates appears to decrease in pediatric patients with community-associated SSTI caused by S. aureus. Clinicians should be aware of regional susceptibility patterns when choosing empirical regimens.
Child ; Humans ; Methicillin Resistance ; Observational Study ; Oxacillin ; Retrospective Studies ; Skin ; Soft Tissue Infections ; Staphylococcal Skin Infections ; Staphylococcus aureus ; Staphylococcus ; Tetracycline