Clinical, Microbial, and Biochemical Aspects of the Exfoliative Toxins Causing Staphylococcal Scalded-Skin Syndrome

1999 ◽  
Vol 12 (2) ◽  
pp. 224-242 ◽  
Author(s):  
Shamez Ladhani ◽  
Christopher L. Joannou ◽  
Denise P. Lochrie ◽  
Robert W. Evans ◽  
Susan M. Poston
Keyword(s):  
Clinical Features ◽  
Treatment Options ◽  
Entire Body ◽  
Secondary Complications ◽  
Staphylococcal Scalded Skin Syndrome ◽  
Treatment And Prevention ◽  
Causative Agents ◽  
Underlying Diseases ◽  
Disease Understanding ◽  
Significant Mortality

SUMMARY The exfoliative (epidermolytic) toxins of Staphylococcus aureus are the causative agents of the staphylococcal scalded-skin syndrome (SSSS), a blistering skin disorder that predominantly affects children. Clinical features of SSSS vary along a spectrum, ranging from a few localized blisters to generalized exfoliation covering almost the entire body. The toxins act specifically at the zona granulosa of the epidermis to produce the characteristic exfoliation, although the mechanism by which this is achieved is still poorly understood. Despite the availability of antibiotics, SSSS carries a significant mortality rate, particularly among neonates with secondary complications of epidermal loss and among adults with underlying diseases. The aim of this article is to provide a comprehensive review of the literature spanning more than a century and to cover all aspects of the disease. The epidemiology, clinical features, potential complications, risk factors, susceptibility, diagnosis, differential diagnoses, investigations currently available, treatment options, and preventive measures are all discussed in detail. Recent crystallographic data on the toxins has provided us with a clearer and more defined approach to studying the disease. Understanding their mode of action has important implications in future treatment and prevention of SSSS and other diseases, and knowledge of their specific site of action may provide a useful tool for physiologists, dermatologists, and pharmacologists.

scholarly journals S. pseudintermedius and S. aureus lineages with transmission ability circulate as causative agents of infections in pets for years

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Laura Ruiz-Ripa ◽  
Carmen Simón ◽  
Sara Ceballos ◽  
Carmelo Ortega ◽  
Myriam Zarazaga ◽  
...  
Keyword(s):  
Treatment Options ◽  
Companion Animals ◽  
Clinical History ◽  
Multidrug Resistant ◽  
Hospital Environment ◽  
Antimicrobial Resistance Profile ◽  
Causative Agents ◽  
Veterinary Hospital ◽  
Coagulase Positive Staphylococci

Abstract Background Staphylococcus pseudintermedius (SP) and Staphylococcus aureus (SA) are common colonizers of companion animals, but they are also considered opportunistic pathogens, causing diseases of diverse severity. This study focused on the identification and characterization of 33 coagulase-positive staphylococci isolated from diseased pets (28 dogs and five cats) during 2009–2011 in a veterinary hospital in Spain in order to stablish the circulating lineages and their antimicrobial resistance profile. Results Twenty-eight isolates were identified as SP and five as SA. Nine methicillin-resistant (MR) isolates (27%) carrying the mecA gene were detected (eight MRSP and one MRSA). The 55% of SP and SA isolates were multidrug-resistant (MDR). MRSP strains were typed as ST71-agrIII-SCCmecII/III-(PFGE) A (n=5), ST68-agrIV-SCCmecV-B1/B2 (n=2), and ST258-agrII-SCCmecIV-C (n=1). SP isolates showed resistance to the following antimicrobials [percentage of resistant isolates/resistance genes]: penicillin [82/blaZ], oxacillin [29/mecA] erythromycin/clindamycin [43/erm(B)], aminoglycosides [18–46/aacA-aphD, aphA3, aadE], tetracycline [71/tet(M), tet(K)], ciprofloxacin [29], chloramphenicol [29/catpC221], and trimethoprim-sulfamethoxazole [50/dfrG, dfrK]. The dfrK gene was revealed as part of the radC-integrated Tn559 in two SP isolates. Virulence genes detected among SP isolates were as follow [percentage of isolates]: siet [100], se-int [100], lukS/F-I [100], seccanine [7], and expB [7]. The single MRSA-mecA detected was typed as t011-ST398/CC398-agrI-SCCmecV and was MDR. The methicillin-susceptible SA isolates were typed as t045-ST5/CC5 (n=2), t10576-ST1660 (n=1), and t005-ST22/CC22 (n=1); the t005-ST22 feline isolate was PVL-positive and the two t045-ST45 isolates were ascribed to Immune Evasion Cluster (IEC) type F. Moreover, the t10576-ST1660 isolate, of potential equine origin, harbored the lukPQ and scneq genes. According to animal clinical history and data records, several strains seem to have been acquired from different sources of the hospital environment, while some SA strains appeared to have a human origin. Conclusions The frequent detection of MR and MDR isolates among clinical SP and SA strains with noticeable virulence traits is of veterinary concern, implying limited treatment options available. This is the first description of MRSA-ST398 and MRSP-ST68 in pets in Spain, as well the first report of the dfrK-carrying Tn559 in SP. This evidences that current transmissible lineages with mobilizable resistomes have been circulating as causative agents of infections among pets for years.

scholarly journals Complete splenic infarction in association with COVID-19

2021 ◽  
Vol 14 (12) ◽  
pp. e246274
Author(s):  
Graham Prentice ◽  
Stephen Wilson ◽  
Alexander Coupland ◽  
Stephen Bicknell
Keyword(s):  
Respiratory System ◽  
Splenic Infarction ◽  
Thromboembolic Complications ◽  
Secondary Complications ◽  
High Incidence ◽  
Disease Understanding

COVID-19 predominantly affects the respiratory system. As a novel disease, understanding of its management and complications continues to grow. Herein, we present a case of almost complete splenic infarction in a patient with COVID-19 pneumonia. This case highlights the need to maintain diagnostic vigilance whilst investigating secondary complications of COVID-19. It is also important to stress the high incidence of thromboembolic complications in patients with COVID-19, which may occur anywhere in the vasculature.

scholarly journals Clinical and immunological characteristic of children with congenital infections and perinatal HIV contact, considering their HIV status

2020 ◽  
Vol 65 (3) ◽  
pp. 78-83
Author(s):  
V. B. Denisenko ◽  
E. M. Simovanyan
Keyword(s):  
Immune System ◽  
Clinical Features ◽  
Molecular Genetic ◽  
Hiv Positive ◽  
Hiv Status ◽  
Congenital Infections ◽  
Treatment And Prevention ◽  
Perinatal Hiv ◽  
Immunological Examination ◽  
Simplex Virus

Relevance. The study of the etiological structure, clinical features of congenital infections and the immune status of children with perinatal HIV contact will help to improve the program for the diagnosis, treatment and prevention of these diseases.Objective. To characterize the clinical features of congenital infections and changes in the immune system in children with perinatal HIV contact, taking into account their HIV status.Methods. A clinical, serological, molecular genetic, cytological, immunological examination of 203 children with perinatal HIV contact, including 91 HIV-positive patients and 112 HIV-negative patients.Results. Congenital infections were diagnosed in 43.3% of children with perinatal HIV contact. They were characterized by a predominance of cytomegalovirus (30%) and Chlamydia trachomatis (14.3%) in the etiological structure; those infections proceeded as a mono-infection (61.4%) or in a localized form (52.5%). In the group of HIV-positive children, congenital infections developed in 68.1% of patients. In most cases congenital infections were caused by cytomegalovirus (45.1%), herpes simplex virus (6.6%) and bacteria (11%); they proceeded as an associated infection (46.8%), and in a clinically manifest localized (61.3%) and generalized forms (33.9%). The clinical features of congenital infections in HIV-infected children were associated with more significant disorders in the immune system, especially in T-cell link.Conclusion. The revealed clinical and immunological features of congenital infections in children with perinatal HIV contact must be considered during diagnostic, therapeutic and preventive procedures.

scholarly journals Molecular Diagnostics and Biological Safety 2021. COVID-19: Epidemiology, Diagnosis and Prophylaxis: Conference Abstracts

2021 ◽  
Keyword(s):  
Clinical Features ◽  
Molecular Diagnostics ◽  
Distress Syndrome ◽  
Treatment Options ◽  
Educational Institutions ◽  
Diagnostic Tools ◽  
Post Vaccination ◽  
Medical Practitioners ◽  
Coronavirus Infection ◽  
Post Infectious

The pandemic of the new coronavirus infection has spread to more than 200 countries. To date, over 130 million people have been affected and over 2.8 million have died. COVID-19 infection has a number of specific epidemiological and clinical features. In severe cases of the disease, acute respiratory distress syndrome develops, which is often fatal. The SARS-CoV-2 virus is susceptible to mutations, which alarms the scientific community all over the world. Therefore, scientific research in the field of COVID-19, the search for new diagnostic tools, methods for nonspecific and specific prevention and treatment are central topics today.This collection contains abstracts submitted by leading experts in the field of epidemiology, clinics of infectious diseases, molecular diagnostics, young researchers and medical practitioners. Published materials contain data on the methods of molecular diagnostics of COVID-19, se-quencing of the SARS-CoV-2 genome, epidemiology of new coronavirus infection, immuno-pathogenesis of COVID-19, clinical features of infection and treatment options, as well as the study of post-infectious and post-vaccination immunity and examples of complex measures for nonspecific prevention of COVID-19.The materials of the Congress are of interest to doctors and researchers of all specialties, teachers of secondary and higher educational institutions.

Thyreotoxische Krise und Myxödemkoma

2018 ◽  
Vol 143 (06) ◽  
pp. 397-405 ◽  
Author(s):  
Malte Milkau ◽  
Friedhelm Sayk
Keyword(s):  
Thyroid Dysfunction ◽  
Treatment Options ◽  
Signs And Symptoms ◽  
Diagnostic Tools ◽  
Thyroid Storm ◽  
Thyreotoxische Krise ◽  
Myxedema Coma ◽  
Clinical Forms ◽  
Medical Emergencies ◽  
Significant Mortality

AbstractThyroid storm and myxedema coma are the most severe clinical forms of thyroid dysfunction. While both hyper- and hypothyroidsm are common diseases, thyroid storm and myxedema coma are rare. Due to their unspecific signs and symptoms they are often difficult to diagnose. Both disorders are medical emergencies, which still show a significant mortality. The following article summarizes diagnostic tools and treatment options for these disorders

Special psychiatric problems relating to gambling

2012 ◽  
pp. 919-923
Author(s):  
Emanuel Moran
Keyword(s):  
Clinical Features ◽  
Random Processes ◽  
Predisposing Factors ◽  
Treatment And Prevention ◽  
Property Transfer ◽  
Psychiatric Problems

Gambling is an activity with the following elements: A contract between two or more people, which is based on a forecast of the outcome of an uncertain event involving random processes; Property, referred to as the stake, is transferred between those taking part, so that some gain at the expense of others; The property transfer depends on the outcome or result of the uncertain event, which has been forecast; Participation is voluntary and not necessarily related to gaining the property, but used to obtain an experience. This chapter discusses the clinical features, classification, aetiology and epidemiology, diagnosis, predisposing factors, course and prognosis, management and treatment, and prevention.

scholarly journals How and why SGLT2 inhibitors should be explored as potential treatment option in diabetic retinopathy: clinical concept and methodology

2019 ◽  
Vol 10 ◽  
pp. 204201881989188 ◽  
Author(s):  
Marcus May ◽  
Theodor Framke ◽  
Bernd Junker ◽  
Carsten Framme ◽  
Amelie Pielen* ◽  
...  
Keyword(s):  
Treatment Option ◽  
Microvascular Complications ◽  
Treatment Options ◽  
Sglt2 Inhibitors ◽  
Diabetic Microangiopathy ◽  
Potential Treatment ◽  
Treatment And Prevention ◽  
Clinical Complications ◽  
Sodium Glucose Cotransporter ◽  
Increased Risk

Patients suffering from type 2 diabetes are at an increased risk of developing classical microvascular complications such as retinopathy, neuropathy, and nephropathy, which represent a significant health burden. Tight control of blood glucose, blood pressure, and serum cholesterol reduce the risk of microvascular complications but effective pharmacologically targeted treatment options for the treatment and prevention of diabetic microangiopathy are still lacking. Pharmacological inhibition of sodium glucose cotransporter 2 (SGLT2) might have the potential to directly protect against microvascular complications and could represent a potential treatment option. Randomized controlled clinical proof of concept trials are needed to investigate a potential central role of SGLT2 inhibitors in the prevention of diabetic microangiopathy and its classical clinical complications of retinopathy, neuropathy, and nephropathy.

Immunomodulation in Autoimmune Interstitial Lung Disease

Respiration ◽  
2020 ◽  
Vol 99 (10) ◽  
pp. 819-829
Author(s):  
Benjamin Seeliger ◽  
Antje Prasse
Keyword(s):  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Systemic Disease ◽  
Treatment Options ◽  
Interstitial Lung Diseases ◽  
Treatment Modalities ◽  
Established Disease ◽  
Synthetic Dmards ◽  
New Treatment ◽  
Underlying Diseases

Interstitial lung diseases (ILDs) associated with autoimmune or systemic disease are increasingly recognized and our pathophysiological understanding rapidly expanding. Treatment modalities, however, are still mainly driven by established disease-modifying antirheumatic drugs (DMARDs) where, despite decades of experience of their use in the underlying diseases such as rheumatoid arthritis, mostly ret­rospective data exist informing their effect on the course of interstitial lung disease (ILD). In recent years, randomized trials investigating the effects of biological DMARDs (bDMARDs) have been completed or are currently running, generating new treatment options for often relentlessly progressive diseases. Herein, we summarize the evidence and current use of both synthetic DMARDs and bDMARDs in the context of ILDs associated with autoimmune/systemic disease.

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