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Toxic shock syndrome caused by staphylococcal enterotoxin B. A report of 2 cases in children
Insights
Two children experienced severe toxic shock syndrome (TSS) due to Staphylococcus infection, presenting with fever, rash, and organ dysfunction. Enterotoxin B antibodies indicated the staphylococcal toxin as the likely cause of TSS.
Area of Science:
- Pediatric Infectious Diseases
- Toxicology
- Bacterial Pathogenesis
Background:
- Osteomyelitis and staphylococcal septicaemia can lead to severe systemic illness.
- Toxic Shock Syndrome (TSS) is a serious condition characterized by multi-organ dysfunction.
Observation:
- Two pediatric cases presented with fever, shock, scarlatiniform rash, and diffuse mucositis.
- Clinical manifestations included jaundice, renal impairment, myalgia, and neurological signs.
- Specific complications observed were toxic myocarditis in one child and thrombocytopenia in the other.
Findings:
- Both patients exhibited a significant increase in antibody titers against staphylococcal enterotoxin B.
- This suggests a strong correlation between Staphylococcus-produced enterotoxin B and the development of TSS in these cases.
Implications:
- Highlights the critical role of staphylococcal toxins, specifically enterotoxin B, in pediatric toxic shock syndrome.
- Emphasizes the need for prompt recognition and management of severe staphylococcal infections presenting with TSS-like symptoms.
- Informs clinical practice regarding diagnostic markers and potential therapeutic targets in severe staphylococcal toxic shock.
Abstract:
Two children with osteomyelitis, staphylococcal septicaemia and toxic shock syndrome (TSS) are reported. Both patients presented with fever, shock, scarlatiniform rash and diffuse mucositis. The multi-organ dysfunction which characterizes this syndrome was apparent in both patients, who had jaundice, functional renal impairment, diffuse myalgia and non-localizing neurological signs. One child developed toxic myocarditis and the other thrombocytopenia. Both showed a significant rise in antibody titre to enterotoxin B produced by the offending staphylococci, suggesting that this toxin was responsible for the TSS.