A recalcitrant, erythematous, desquamating disorder associated with toxin-producing staphylococci in patients with AIDS

Lawrence A Cone; David R Woodard; Richard G Byrd; Karl Schulz; Stephen M Kopp; Patrick M Schlievert

doi:10.1093/infdis/165.4.638

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A recalcitrant, erythematous, desquamating disorder associated with toxin-producing staphylococci in patients with AIDS

Journal article

Peer reviewed

A recalcitrant, erythematous, desquamating disorder associated with toxin-producing staphylococci in patients with AIDS

Lawrence A Cone, David R Woodard, Richard G Byrd, Karl Schulz, Stephen M Kopp and Patrick M Schlievert

The Journal of infectious diseases, Vol.165(4), pp.638-643

04/1992

DOI: 10.1093/infdis/165.4.638

PMID: 1552193

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Abstract

Although staphylococcal infections are common in patients with AIDS, staphylococcal toxin-related disorders have rarely been described. Five cases of a staphylococcal toxin-associated syndrome characterized by prolonged erythema, extensive cutaneous desquamation, hypotension, tachycardia, and multiple organ involvement are described in patients with AIDS. These illnesses were recurrent and recalcitrant with a mean duration of 50 days. Toxic shock syndrome toxin-1-producing staphylococci were isolated from three and staphylococcal enterotoxins B and A from one patient each. Sources of organisms were blood, one patient, and soft tissues and nasal accessory sinuses, two patients each. Three of the five patients died of renal failure and central nervous system abnormalities. One survivor required intubation for respiratory failure. All individuals manifested a marked diminution of CD4+ cells. Other laboratory abnormalities included azotemia and prolongation of partial thromboplastin time. Oliguria occurred in three patients. Thus, this recalcitrant erythematous desquamative disorder appears to be a variant of staphylococcal toxic shock syndrome in certain subsets of immunocompromised individuals.

Staphylococcal Skin Infections - complications

Staphylococcus aureus - isolation & purification

Humans

Middle Aged

Shock, Septic - complications

Male

Staphylococcus aureus - pathogenicity

Syndrome

Enterotoxins - biosynthesis

Bacterial Toxins

Superantigens

Adult

Acquired Immunodeficiency Syndrome - complications

Erythema

Details

Title: Subtitle: A recalcitrant, erythematous, desquamating disorder associated with toxin-producing staphylococci in patients with AIDS
Creators: Lawrence A Cone - Department of Medicine, Eisenhower Medical Center, Rancho Mirage, California 92270
David R Woodard
Richard G Byrd
Karl Schulz
Stephen M Kopp
Patrick M Schlievert
Resource Type: Journal article
Publication Details: The Journal of infectious diseases, Vol.165(4), pp.638-643
DOI: 10.1093/infdis/165.4.638
PMID: 1552193
NLM abbreviation: J Infect Dis
ISSN: 0022-1899
eISSN: 1537-6613
Publisher: United States
Language: English
Date published: 04/1992
Academic Unit: Microbiology and Immunology; Internal Medicine
Record Identifier: 9984001228802771

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