Toxin Mediated Staph and Strep Disease

Pathogenesis > Infectious Disease > Bacteria > Toxin Mediated Staph and Strep Disease

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•	toxic shock syndrome

•	Scarlet fever

•

SSSS

•	toxin mediated erythema

•

REDD

•	recurrent toxin mediated perineal erythema

•	necrotizing fasciitis

•	food poisoning

•

other:

•	Kawasaki disease (?)

•	guttate psoriasis (?)

•	atopic dermatitis (?)

Common physical signs present in toxin-mediated illness (of staph and strep):

•	strawberry tongue

•	acral erythema (with subsequent desquamation)

•	erythematous eruption with perineal accentuation

Cytokines TNF-alpha and IL-1:

•	fever, rash, emesis

•	hypotension, tissue injury, shock

The majority of these toxins produce their clinical effects in large part by functioning as superantigens

Toxin: Disease:

TSST-1 (-->TNF-alpha and IL-1)

TSS, RED syndrome, RPE, KD, and possibly AD

SEB, SEC

some of the non-menstual TSS

SPE-A (--> TNF-alpha and IL-1)

strep TSS

ETA and ETB

SSSS; bullous impetigo

•	TSST-1 – toxic shock staphylococcal toxin

•	SEB – staph enterotoxin B

•	SEC – staph enterotoxin C

•	SPE-A – streptococcal pyrogenic exotoxin A

•	ETA - exfoliative toxin A

•	ETB - exfoliative toxin B

•	TSS = toxic-shock syndrome

•	SSSS = staph scalded skin syndrome

•	REDD = recalcitrant erythematous desquamating disorder

•	KD = Kawasaki disease

•	AD = atopic dermatitis

•	RPE = recurrent perineal erythema