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Kawasaki syndrome-like illness associated with infection caused by enterotoxin B-secreting Staphylococcus aureus
1Department of Pediatrics, The University of Texas Health Science Center at San Antonio, 78284-7811, USA.
Insights
Two children with Kawasaki syndrome experienced Staphylococcus aureus bacteremia. Superantigens from S. aureus may contribute to the development of this inflammatory condition.
Area of Science:
- Pediatric Infectious Diseases
- Immunology
- Microbiology
Background:
- Kawasaki syndrome is an acute febrile illness primarily affecting young children, characterized by systemic vasculitis.
- The etiology of Kawasaki syndrome remains largely unknown, although infectious triggers are suspected.
- Staphylococcus aureus is a common pathogen, but its role in Kawasaki syndrome is not well-defined.
Observation:
- Two pediatric cases presented with clinical signs meeting Kawasaki syndrome criteria, concurrent with Staphylococcus aureus bacteremia.
- One child exhibited focal osteomyelitis, progressing to multifocal osteomyelitis, confirmed radiographically.
- The S. aureus isolates from both patients produced staphylococcal enterotoxin B and lacked toxic shock syndrome toxin.
Findings:
- The study identified a temporal association between Staphylococcus aureus bacteremia and Kawasaki syndrome in two children.
- Evidence suggests that S. aureus, specifically through the secretion of staphylococcal enterotoxin B, may be implicated in the pathogenesis.
- The findings point to a potential role for staphylococcal and streptococcal superantigens in Kawasaki syndrome or similar illnesses.
Implications:
- These findings suggest that Staphylococcus aureus superantigens could be a contributing factor in some Kawasaki syndrome cases.
- Further research into the role of bacterial superantigens may elucidate the pathogenesis of Kawasaki syndrome.
- This could potentially lead to new diagnostic or therapeutic strategies for Kawasaki syndrome and related inflammatory conditions.
Abstract:
Two children had symptoms and clinical signs that were characteristic of the diagnostic criteria for Kawasaki syndrome, temporally associated with Staphylococcus aureus bacteremia. One child initially had focal osteomyelitis that was evident clinically and radiographically, and radiographic evidence of multifocal osteomyelitis was noted at follow-up. The blood-borne S. aureus isolates from these two patients secreted staphylococcal enterotoxin B and were negative for toxic shock syndrome toxin. Staphylococcal and streptococcal superantigens may play a role in the pathogenesis of some cases of Kawasaki syndrome or Kawasaki syndrome-like illness.