Staphylococcal enterotoxin B toxic shock syndrome induced by community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA).

Abstract

We herein report a case of toxic shock syndrome (TSS) associated with the 2009 pandemic H1N1 (pH1N1) influenza virus and a community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infection in a 16-year-old Vietnamese girl. Staphylococcal enterotoxin B (SEB) was detected in the patient's serum, and the level of anti-SEB antibodies was found to be elevated. A flow cytometric analysis showed evidence of activated SEB-reactive Vβ3+ and Vβ12+ T cells. These data suggest that the CA-MRSA-induced activation of SEB-reactive T cells may cause TSS in patients with pH1N1 virus infection. Moreover, this is the first report describing immunological confirmation of SEB contributing directly to TSS in a patient fulfilling the diagnostic criteria of TSS.

• Authors: Takeru Kashiwada, Ken Kikuchi, Shinji Abe, Hidehito Kato, Hiroki Hayashi, Taisuke Morimoto, Koichiro Kamio, Jiro Usuki, Shinhiro Takeda, Keiji Tanaka, Ken'ichi Imanishi, Junji Yagi, Arata Azuma, Akihiko Gemma
• Journal: Internal medicine (Tokyo, Japan) (Intern Med) Vol. 51 Issue 21 Pg. 3085-8 ( 2012) ISSN: 1349-7235 [Electronic] Japan
• PMID: 23124156 (Publication Type: Case Reports, Journal Article)

Chemical References

• Anti-Bacterial Agents
• Enterotoxins
• enterotoxin B, staphylococcal

Topics

• Adolescent
• Anti-Bacterial Agents (administration & dosage)
• Community-Acquired Infections (drug therapy, etiology, microbiology)
• Enterotoxins (toxicity)
• Female
• Humans
• Influenza A Virus, H1N1 Subtype
• Influenza, Human (complications)
• Methicillin-Resistant Staphylococcus aureus
• Pneumonia, Staphylococcal (drug therapy, etiology, microbiology)
• Shock, Septic (drug therapy, etiology, microbiology)
• Staphylococcal Infections (drug therapy, etiology, microbiology)