Cribier B, Piemont Y, Grosshans E
Clinique Dermatologique, Hôpitaux Universitaires de Strasbourg, France.
J Am Acad Dermatol. 1994 Feb;30(2 Pt 2):319-24. doi: 10.1016/s0190-9622(94)70032-x.
Staphylococcal scalded skin syndrome is rarely observed in adults; only 32 cases have been reported. In contrast to infant cases, the mortality rate is high. Two major risk factors have been identified: kidney failure and immunosuppression. In adults, clinical features are similar to those of the typical pediatric disease, but blood cultures are often positive for Staphylococcus aureus. Detection of the exfoliative toxin is required for diagnosis; the newborn mouse bioassay is, therefore, usually performed. New immunologic methods allow precise characterization of the toxins and oligonucleotide probes can be used for rapid detection of toxigenic strains. We report a case of staphylococcal scalded skin syndrome in an immunocompetent adult in whom blood cultures were positive; this is the first case in which both exfoliative toxins A and B have been identified in an adult.
葡萄球菌烫伤样皮肤综合征在成人中很少见，仅报告过32例。与婴儿病例不同，其死亡率很高。已确定两个主要危险因素：肾衰竭和免疫抑制。在成人中，临床特征与典型的儿科疾病相似，但血培养通常为金黄色葡萄球菌阳性。诊断需要检测剥脱毒素，因此通常进行新生小鼠生物测定。新的免疫方法可对毒素进行精确鉴定，寡核苷酸探针可用于快速检测产毒菌株。我们报告一例免疫功能正常的成人葡萄球菌烫伤样皮肤综合征病例，其血培养呈阳性；这是首例在成人中同时鉴定出剥脱毒素A和B的病例。
