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The following text is from an archived Red Book® edition and may not reflect current recommendations or information. To view the current edition, click here.

The first 300 words of the full text of this section appear below.

Section 3. Summaries of Infectious Diseases

Staphylococcal Infections

Clinical Manifestations
Etiology
Epidemiology
Diagnostic Tests
Treatment
Isolation of the Hospitalized Patient
Control Measures

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CLINICAL MANIFESTATIONS: Staphylococcus aureus causes a variety of localized and invasive suppurative infections and 3 toxin-mediated syndromes: toxic shock syndrome (see Toxic Shock Syndrome, p 660), scalded skin syndrome, and food poisoning (see Staphylococcal Food Poisoning, p 597). Localized infections include hordeola, furuncles, carbuncles, impetigo (bullous and nonbullous), paronychia, ecthyma, cellulitis, omphalitis, parotitis, lymphadenitis, and wound infections. Staphylococcus aureus also causes foreign body infections, including infections associated with intravascular catheters or grafts, pacemakers, peritoneal catheters, cerebrospinal fluid shunts, and prosthetic joints, which can be associated with bacteremia. Bacteremia can be complicated by septicemia; endocarditis; pericarditis; pneumonia; pleural empyema; soft tissue, muscle, or visceral abscesses; arthritis; osteomyelitis; septic thrombophlebitis of large vessels; and other foci of infection. Meningitis is rare. Staphylococcus aureus infections can be fulminant and commonly are associated with metastatic foci and abscess formation, often requiring prolonged antimicrobial therapy, drainage, and foreign body removal to achieve cure. Risk factors for severe S aureus infections include chronic diseases, such as diabetes mellitus and cirrhosis, immunodeficiency, nutritional disorders, surgery, and transplantation.

Staphylococcal scalded skin syndrome (SSSS) is a toxin-mediated disease caused by circulation of exfoliative toxins A and B produced by S aureus. The manifestations of SSSS are age related and include Ritter disease (generalized exfoliation) in the neonate, a tender scarlatiniform eruption and localized bullous impetigo in older children, and a combination of these with thick white/brown flaky desquamation of the entire skin, especially on the face and neck, in older infants and toddlers. The hallmark of SSSS is the toxin-mediated cleavage of the stratum granulosum layer of the epidermis. Healing occurs without scarring. Bacteremia is rare, but dehydration and superinfection can occur with extensive . . . [Go to Full Text]


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Staphylococcal Food Poisoning
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