Abstract
Six otherwise normal children (ages 8-16 years) have presented sporadically in 1977 with a clinically distinct syndrome of high fever (40-41°C), headache, confusion, conjuctival hyperemia, a diffuse scarlatinaform erythroderma, subcutaneous edema, vomiting, watery diarrhea, hypotension, oliguria, and a propensity to develop acute renal failure, hepatic abnormalities, D.I.C., and severe prolonged shock. One patient died, one developed gangrene of the toes, and all have had fine desquamation of affected skin surfaces as well as marked peeling of palms and soles during convalescence. All five patients studied prospectively have grown phage group I Staphylococcus aureus from mucosal sites (nasopharyngeal, vaginal, tracheal) but not from the blood or CSF. These organisms have been shown to produce a toxin which causes a positive Nikolsky's sign in the newborn mouse model but is biochemically, pathologically, and immunologically distinct from the phage group II staphylococcal exfoliatin. Only one of seven contacts and 0/3 older children with other febrile exanthematous illness grew a similar phage group I staphylococcus. The toxic shock syndrome appears to be a dramatic new clinical entity possibly related to toxin production by certain staphylococci.
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Todd, J., Kapral, F., Fishaut, M. et al. 820 TOXIC SHOCK SYNDROME ASSOCIATED WITH PHAGE GROUP I STAPHYLOCOCCI. Pediatr Res 12 (Suppl 4), 500 (1978). https://doi.org/10.1203/00006450-197804001-00825
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DOI: https://doi.org/10.1203/00006450-197804001-00825
