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Titolo:
Clinical aspects of staphylococcal and streptococcal toxinic diseases
Autore:
Floret, D;
Indirizzi:
Hop Edouard Herriot, Serv Urgence & Reanimat Pediat, F-69437 Lyon 03, France Hop Edouard Herriot Lyon France 03 nimat Pediat, F-69437 Lyon 03, France
Titolo Testata:
ARCHIVES DE PEDIATRIE
, volume: 8, anno: 2001, supplemento:, 4
pagine: 762S - 768S
SICI:
0929-693X(200109)8:<762S:CAOSAS>2.0.ZU;2-L
Fonte:
ISI
Lingua:
FRE
Soggetto:
INFANT-DEATH-SYNDROME; SCALDED-SKIN SYNDROME; SHOCK-LIKE SYNDROME; PYROGENIC TOXINS; CHILDREN; AUREUS;
Keywords:
child; shock septic; staphylococcal infections; staphylococcal scaled skin syndrome streptococcal infections; toxins;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
25
Recensione:
Indirizzi per estratti:
Indirizzo: Floret, D Hop Edouard Herriot, Serv Urgence & Reanimat Pediat, Pl Arsonval, F-69437 Lyon 03, France Hop Edouard Herriot Pl Arsonval Lyon France 03 Lyon 03, France
Citazione:
D. Floret, "Clinical aspects of staphylococcal and streptococcal toxinic diseases", ARCH PED, 8, 2001, pp. 762S-768S

Abstract

Staphylococcus aureus and Streptococcus pyogenes produce a lot of toxins, some of them responsible for specific diseases. Staphylococcal food poisonning is due to ingestion of enterotoxin containing food. Seven toxins have been isolated so far. Generalized exfoliative syndrome is related to exfo-liatin. Young children are particulary affected. The disease consists in a cutaneous exfoliation usually limited with a favourable outcome. The mucus membranes are not involved. The nose or pharynx are the most usual portal of entry. Staphylococcus aureus is not grown from the bullae. Severe extensiveforms have been observed particulary in neonates (Ritter's disease). Bullous impetigo is also due to exfoliatin. It consists in the presence of a restricted number of cloudy bullae, from wich staphylococcus can be grown. It is a mild disease with a favourable outcome within a few days. Scarlet fever is related to the streptococcal erythrogenic toxins. The classic form of the disease is presently rare. This disease may be related to staphylococcus as a complication of arthritis, osteomyelitis or wound superinfection. Bacteremia is usual. Staphylococcal scarlet fever is not related to exfoliatin as previously believed, but to enterotoxins or TSST-1, so it seems to be an abortive form of toxic shook syndrome. Toxic shock syndrome is defined as a multi organ failure syndrome with a rapid onset, fever, rash followed by desquamation, vomiting and diarrhea, hypotension, conjunctivitis and strawberry tongue. The disease is related to an infection or colonisation with a toxin (TSST-1) producing strain of Staphylococus aureus. Enterotoxins (mainly C) may be involved. The disease may occur in childhood, sometimes after superinfection of varicella. The mortality is low (5%) and mainly due to ARDS or cardiac problems. Erythrogenic toxins produced by Streptococcus pyogenes are involved in a streptococcal form of toxic shock syndrome with a quite similar presentation. In most cases however, a cutaneous or soft tissue infection is at the origin. Necrotizing fasciitis complicating varicella is a classic cause in children. Bacteremia is often observed. The mortality, rate is as high as 60%. The streptococcal strains involved in north america use to produce the toxin erythrogenic A, the european cases seem to be more related to strains secreting the B toxin with a dysregulation of the mecanisms wich control the secretion of the toxin. Staphylococcus strains producing the Panton and Valentine leucocidin are responsible for chronic or relapsing furonculosis and above all for a very severe necrotizing pneumoniaobserved in children and young adults presenting as an acute respiratory distress syndrome with leucopenia, hemoptysis and shock carying a heavy mortality rate. Besides these specific diseases, staphylococcal and streptococcal toxins may be involved in some syndromes of unknown origin, in wich the intervention of superantigens seems very likely. Kawasaki syndrome is amongthem as strains producing staphylococcal and streptococcal toxins have been grown from patients with Kawasaki syndrome. In the same way, the intervention of toxins is suspected in the determination of sudden infant death syndrome and atopic eczema. (C) 2001 Editions scientifiques et medicales Elsevier SAS.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 29/11/20 alle ore 00:59:15