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Mild forms of toxic shock syndrome toxin-1-mediated exanthematous disease related to Staphylococcus aureus infection

Naohiko Moriguchi1, Tomowa Kano1, Yutaka Yoshimatsu1

  • 1Department of Pediatrics, Sakai Hospital Kinki University Faculty of Medicine, Japan.

Journal of Infection and Chemotherapy : Official Journal of the Japan Society of Chemotherapy
|March 1, 2016
PubMed

Insights

This study details three cases of toxic shock syndrome toxin-1 (TSST-1) exanthematous disease. Early T-cell receptor Vβ2 measurement aided diagnosis, distinguishing it from severe toxic shock syndrome.

Area of Science:

  • Infectious Diseases
  • Immunology
  • Dermatology

Background:

  • Toxic Shock Syndrome (TSS) is a severe, life-threatening illness caused by toxins, primarily toxic shock syndrome toxin-1 (TSST-1).
  • Exanthematous disease associated with TSST-1, distinct from classic TSS, presents unique diagnostic challenges.

Observation:

  • Three patients presented with fever and systemic erythema following lower limb cellulitis.
  • TSST-1 producing Methicillin-susceptible Staphylococcus aureus was identified at the infection site in all cases.
  • Patients did not meet the full clinical criteria for toxic shock syndrome.

Findings:

  • Prompt antimicrobial treatment led to defervescence and resolution of erythema, preventing severe illness.
  • Measurement of T-cell receptor Vβ2-positive T cells in peripheral blood early in the disease course proved diagnostically useful.
  • This suggests a specific immune response pattern in TSST-1 associated exanthematous disease.

Implications:

  • Early identification and treatment of TSST-1 associated exanthematous disease can prevent severe outcomes.
  • T-cell receptor Vβ2 analysis may serve as a valuable diagnostic biomarker for this condition.
  • Understanding this distinct clinical entity improves patient management and diagnostic accuracy in staphylococcal infections.
Keywords:
Exanthematous diseaseStaphylococcus aureusSuperantigenToxic shock syndrome toxin-1Vβ2-positive T cells

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