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Staphylococcal septicemia in children with atopic dermatitis
P H Hoeger1, R Ganschow, G Finger
1Department of Pediatrics, University of Hamburg, Hamburg, Germany. phhoeger@t-online.de
Insights
Severe bacterial infections, like staphylococcal septicemia, can occur in children with atopic dermatitis (AD). Underlying conditions may increase the risk of these serious skin infections in AD patients.
Area of Science:
- Pediatric Dermatology
- Infectious Diseases
- Immunology
Background:
- Atopic dermatitis (AD) commonly presents with bacterial skin superinfections.
- Invasive bacterial infections, such as osteomyelitis, are rare complications of AD.
- Systemic staphylococcal infections are not frequently reported in pediatric AD cases.
Observation:
- This report details two pediatric cases of staphylococcal septicemia during AD exacerbations.
- Predisposing factors included cellulitis and congenital heart disease.
- Identical bacterial strains were isolated from skin lesions, and one child showed increased antibodies to Staphylococcus aureus.
Findings:
- The cases highlight the potential severity of bacterial skin infections in AD.
- Underlying conditions can increase vulnerability to bacteremia in children with AD.
- Systemic staphylococcal infections might be more prevalent than previously recognized in pediatric AD.
Implications:
- Staphylococcal bacteremia should be considered in the differential diagnosis of fever in children with severe AD.
- Episodes of staphylococcal bacteremia warrant investigation for underlying predisposing factors, including AD.
- Increased awareness can improve early diagnosis and management of invasive infections in vulnerable pediatric populations.
Abstract:
Atopic dermatitis (AD) is frequently complicated by minor bacterial superinfections. Invasive infections such as osteomyelitis have rarely been reported. We describe two children with staphylococcal septicemia during an exacerbation of their AD. Cellulitis and underlying congenital heart disease, respectively, were considered predisposing factors for the development of bacteremia. Identical strains were isolated from the skin, and there was a significant increase in antibodies against Staphylococcus aureus capsular polysaccharide in one child. Our cases demonstrate the potential severity of bacterial skin infections in AD, especially when associated with an underlying condition that increases vulnerability to bacteremia. While their true incidence in children with AD is currently unknown, it is conceivable that systemic staphylococcal infections may be more common than previously thought. Staphylococcal bacteremia has to be considered in the differential diagnosis of fever in children with severe AD. Conversely, episodes of staphylococcal bacteremia should prompt a search for underlying predisposing factors.