A Case Report of Staphylococcal Scalded Skin Syndrome with Toxic Shock Syndrome

Abstract

Toxins produced by bacteria can result into various systemic manifestations through the release of cytokines which leads to changes at the molecular level. This index case of an 18 years old adult immuno-competent male patient, presented with high grade ongoing fever for 3 days, had wound on left arm in deltoid region. there were diffuse maculo-papular rash predominantly in both palms feet and trunk, erythematous and blanchable on examination. Patient was treated with inj. Piperacillin- Tazobactam and Linezolid, i.v. fluids and nor-adrenaline infusion. Patient was diagnosed with concurrent Staphylococcal Scalded Skin Syndrome (SSSS) and Toxic Shock Syndrome (TSS). The two syndromes are caused by different toxins produced by different strains of Staphylococcus aureus. The source of infection was a pus discharging sinus on left arm. The findings were proven on skin biopsy and met the case definition criteria of TSS. He is currently asymptomatic after the treatment being given against Methicillin-resistant Staphylococcus aureus (MRSA) isolated from the pus. It is therefore possible for a single strain of bacteria being capable of producing different toxins, resulting in two different clinical syndromes having a concurrent presentation.

Keywords

• bullous skin lesions
• infectious diseases
• methicillin resistant staphylococcus aureus
• staphylococcus aureus