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

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

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

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

The staphylococcal scalded skin syndrome encompasses a spectrum of blistering skin disease that ranges in severity from localized bullous impetigo to a generalized syndrome with cutaneous tenderness, widespread blistering, and superficial denudation or desquamation. This disorder is induced by the exfoliative toxin of Stapylococcus aureus. The intermediate form of staphylococcal scalded skin syndrome may be seen that begin as localized bullous impetigo but evolve to produce regionally limited bullae and denuded areas that may or may not harbor causative microorganism. We report six cases of the intermediate form of staphylococcal scalded skin syndrome in Daejeon for a short time. All cases occurred in children under 5 years of age and showed localized bullae and erythroderma with positive Nikolsky's sign.
Blister ; Child ; Dermatitis, Exfoliative ; Humans ; Impetigo ; Skin Diseases ; Staphylococcal Scalded Skin Syndrome*

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

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

Although pandemic community-associated (CA-) methicillin-resistant Staphylococcus aureus (MRSA) ST30 clone has successfully spread into many Asian countries, there has been no case in Korea. We report the first imported case of infection caused by this clone in a Korean traveler returning from the Philippines. A previously healthy 30-yr-old Korean woman developed a buttock carbuncle while traveling in the Philippines. After coming back to Korea, oral cephalosporin was given by a primary physician without any improvement. Abscess was drained and MRSA strain isolated from her carbuncle was molecularly characterized and it was confirmed as ST30-MRSA-IV. She was successfully treated with vancomycin and surgery. Frequent international travel and migration have increased the risk of international spread of CA-MRSA clones. The efforts to understand the changing epidemiology of CA-MRSA should be continued, and we should raise suspicion of CA-MRSA infection in travelers with skin infections returning from CA-MRSA-endemic countries.
Adult ; Bacterial Toxins/metabolism ; Carbuncle/microbiology ; Cephalosporins/therapeutic use ; Community-Acquired Infections/drug therapy/microbiology ; Exotoxins/metabolism ; Female ; Humans ; Leukocidins/metabolism ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus/*isolation & purification ; Philippines ; Republic of Korea ; Staphylococcal Skin Infections/*drug therapy/surgery ; Travel ; Vancomycin/therapeutic use

Kerion celsi is an inflammatory infection, caused by a vigorous T-cell mediated host response to the dermatophyte infection. In the case of severe inflammation, it can be misdiagnosed as other disease like cellulitis, impetigo, furuncle and epidermal cyst. Microsporum(M.) canis is most likely transmitted by contact of animal hosts such as cats and dogs with humans. We report the 75-year-old female who presented two months history of tender erythematous scaly plaques with pustules, crusts on right scalp area. At first, from the histopathologic findings of the lesion, the patient was diagnosed epidermal cyst because of cyst-like structure in mid-dermis. But the fungal culture revealed M. canis as the causative fungus. Herein we report a educational case of kerion celsi mistaken for ruptured epidermal cyst.
Aged ; Animals ; Arthrodermataceae ; Cats ; Cellulitis ; Dogs ; Epidermal Cyst* ; Female ; Fungi ; Furunculosis ; Humans ; Impetigo ; Inflammation ; Scalp ; T-Lymphocytes ; Tinea Capitis*

INTRODUCTIONSingapore saw a resurgence of dengue infections in 2005. Concurrent bacterial co-infections in dengue is rare.

CLINICAL PICTUREWe report a cluster of serious methicillin-susceptible Staphylococcus aureus (MSSA) bacteraemia or severe soft tissue infection in 5 epidemiologically linked construction workers presenting with dengue and non-resolving fever.

TREATMENTSurgical intervention was indicated in 4 of the 5 patients despite appropriate antistaphylococcal therapy.

OUTCOMEAll but 1 patient were eventually discharged. Clonality and Panton-Valentine leucocidin genes were not demonstrated. Epidemiological investigations suggested that occupational contact dermatitis could have predisposed the patients to this opportunistic co-infection.

CONCLUSIONClinicians need to be vigilant to unusual manifestations of dengue which may signal a concomitant aetiology.

Adult ; Cluster Analysis ; Dengue ; complications ; epidemiology ; Humans ; Male ; Methicillin ; pharmacology ; Occupations ; Singapore ; epidemiology ; Soft Tissue Infections ; transmission ; Staphylococcal Infections ; complications ; epidemiology ; therapy ; transmission ; Staphylococcal Skin Infections ; transmission ; Staphylococcus aureus ; drug effects