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- W2054034737 abstract "To The Editors: We read with great interest the report of isolation of exfoliative toxin (ET)-producing Staphylococcus aureus in children with suspected staphylococcal scalded skin syndrome (SSSS) by Ladhani et al. 1 The extremely low yield of ET-producing staphylococcal isolates (31.5%) in the study needs further reappraisal with respect to its design. The skin lesions from which these isolates were obtained in this study need further definition. It is obvious from the pathogenesis of SSSS that lesions of generalized SSSS are induced by ET and not by local presence of S. aureus. 2 In fact it is paradoxical to look for the causative organisms in a place where it is supposed to be absent. Generalized SSSS is usually the result of hematogenous spread of ET as a result of localized infection by ET-producing S. aureus at various sites which may not always be cutaneous. 2, 3 The extracutaneous source of ET-producing S. aureus could very well be an ear infection, upper respiratory tract infection, purulent conjunctivitis, umbilical stump infection or an occult infection. 3, 4 In the absence of any such obvious infections, the ET-producing S. aureus should at least be looked for in areas transiently inhabited by S. aureus such as anterior nares, axillae, perineum and toe webs. Moreover the diagnosis of SSSS with isolation of ET-producing S. aureus from the lesions of generalized SSSS makes the diagnosis of generalized SSSS untenable given that isolation of ET-producing S. aureus directly from the lesions would favor the diagnosis of limited SSSS. Anjum Singal, M.D. Gurvinder P. Thami, M.D." @default.
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- W2054034737 date "2003-10-01" @default.
- W2054034737 modified "2023-09-25" @default.
- W2054034737 title "Isolation of exfoliative toxin-producing Staphylococcus aureus" @default.
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- W2054034737 doi "https://doi.org/10.1097/01.inf.0000091385.41048.aa" @default.
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