Staphylococcal Scalded Skin Syndrome, Toxic Shock Syndrome, and Kawasaki Disease

Hansen, Ronald C.

doi:10.1016/s0031-3955(16)34401-7

Cited by 39 publications

(5 citation statements)

References 35 publications

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“…Various infectious agents, including bacterial, viral, chlamydial, and rickettsial organisms, have been implicated as potential causes, as have certain immunologic agents such as bacterial toxin-mediated superantigens. [19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] To date, however, no links have been irrefutably found between any of the above-mentioned individual agents and KD.…”

Section: Discussionmentioning

confidence: 99%

Epidemiologic Features of Kawasaki Disease in Taiwan, 1996–2002

Chang

et al. 2004

Pediatrics

104

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ABSTRACT. Objective. Kawasaki disease (KD) is the most common acquired heart disease in children worldwide. The incidence of KD varies among different countries, with Asian countries supposedly having higher incidences than Western countries. However, the incidence of KD in Taiwan has not been well investigated.Methods. Since the implementation of Taiwan's National Health Insurance (NHI) in 1995, NHI has covered health care for >96% its population. Using the NHI database from 1996 to 2002, we investigated epidemiologic features of KD (International Classification of Diseases, Ninth Revision, code 446.1), the rate of coronary artery aneurysm formation (International Classification of Diseases, Ninth Revision, code 414.11), and the change in incidence during the recent 7 years. We also compared the annual incidences in Taiwan with those reported by other countries.Results. During the 7-year study period, KD occurred most frequently in the summer and least frequently in winter. It is interesting that the highest peak occurred in the summer of 1998 at the same time that Taiwan's enterovirus 71 epidemic was occurring. Ninety-one percent of KD cases occurred in children who were <5 years old, and the male-to-female ratio was 1.70:1. Recurrence of KD was found in 1.3% (94 of 7305) of these children, and coronary artery aneurysm was found in 7.3% (536 of 7305). The annual incidence per 100 000 children was 146 in children <1 year old, 98 in 1-year-old children, 51 in 2-year-old children, 28 in 3-year-old children, 19 in 4-year-old children, and 5.3 in 5-to 9-year-old children; the incidence of KD decreased with increased age. The overall incidence was 66 cases per 100 000 children <5 years old from 1996 to 2002 with the annual incidence not differing significantly during the 7-year study period.Conclusions. KD in Taiwan occurs more frequently in boys and in the summer months. During the 7-year study period, the annual KD incidence in Taiwan of 66/100000 in children <5 years old was the second highest in the world after Japan. Kawasaki,1 it is now the most common cause of acquired heart disease in children in the developed world. Although usually self-limiting, KD is associated with a range of complications, the most important being the development of life-threatening coronary artery abnormalities.Reported incidences of KD in different countries vary widely. For example, Japan has the highest annual incidence in the world. It reported 100 to 110 KD cases per 100 000 children Ͻ5 years old between 1995 and 1998 but with ϳ200 cases per 100 000 in times of epidemic. [2][3][4][5] Beijing reported annual citywide incidence of 18.2 to 30.6 per 100 000 from 1995 to 1999, 6 and Hong Kong reported an annual incidence of 25.4 per 100 000 from 1989 to 1994 and 32 from 1994 to 2000. 7,8 Among the annual incidences reported for Western countries, the United States reported 17.6 and 17.1 cases per 100 000 children Ͻ5 years old in 1997 and 2000, respectively, 9 and from 1996 to 1999, the United Kingdom reported 5.5 per 100 000 childre...

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Section: Discussionmentioning

confidence: 99%

Epidemiologic Features of Kawasaki Disease in Taiwan, 1996–2002

Chang

et al. 2004

Pediatrics

104

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“…Kawasaki's disease usually lacks hypotension, multi-organ involvement, and thrombocytopeni a (14). Interestingly, an erythema multiforme-like rash has been reported in Kawasaki's disease (15).…”

Section: Discussionmentioning

confidence: 99%

Two Men with Toxic Shock Syndrome Presenting with Targetoid and Spotty Skin Rashes

Scheinfeld

Pollack²,

McNiff³

et al. 2002

Acta Dermato-Venereologica

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Two previously healthy men who presented with hypotension, constitutional symptoms, and targetoid and discrete spotty erythematous plaques were diagnosed with toxic shock syndrome based on histopathological findings. Specifically, their biopsies revealed necrotic keratinocytes, neutrophils in the epidermis, and neutrophils surrounding dilated superficial vessels. In one case, the diagnosis of toxic shock syndrome was confirmed with rising titers to toxic shock syndrome toxin-1. Both patients recovered with supportive care and clindamycin administration. We suggest that patients with fever, hypotension, constitutional symptoms and rash should be started on clindamycin and have a skin biopsy as part of their initial evaluation. An understanding that toxic shock syndrome can strike anyone has manifold dermatological manifestations and defined histopathological findings is important for its early diagnosis and effective treatment.

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“…Differentialdiagnostisch sind vom toxischen Schocksyndrom außerdem v. a. bei noch nicht voll ausgeprägter Symptomatik bzw. milderen Verlaufsformen andere mit hohem Fieber und erythematösem Hautausschlag einhergehende Krankheiten abzugrenzen, im Kindesalter besonders das Kawasaki-Syndrom, Scharlach, Erythema multiforme major (Stevens-Johnson-Syndrom) und das ebenfalls durch ein Exotoxin von Staphylokokkus aureus ausgelöste "staphylococcal scaled skin syndrome" (SSSS) (3,14,25). Das Alter der Patienten sowie die Gesamt konstellation der Befunde im weiteren Verlauf können Hinweise für eine diagnostische Abgrenzung geben.…”

Section: Klin Pädiatr 205 (1993) 377unclassified

Menstruelles toxisches Schocksyndrom

Bertram¹,

Wilken²

1993

Klin Padiatr

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A 15 year old girl presented twice with severe symptoms of multiorgan disease during a period of 4 weeks resulting in intensive care necessary to control illness. According to case definition criteria, a toxic shock syndrome was diagnosed on second admission. This could be confirmed by proof of TSST-1. Beside antibiotics, no specific treatment was used and complete clinical recovery occurred with symptomatic therapy. Discussing the menstrual toxic shock syndrome we point out different aspects of the pathogenesis of the disease including the possible role of tampon use. With regard to the results of several investigators, clinical symptoms of toxic shock syndrome could be the consequence of an uncontrolled immunologic reaction. Looking at this concept, more effective therapy may be available in the near future.

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Staphylococcal Scalded Skin Syndrome, Toxic Shock Syndrome, and Kawasaki Disease

Cited by 39 publications

References 35 publications

Epidemiologic Features of Kawasaki Disease in Taiwan, 1996–2002

Epidemiologic Features of Kawasaki Disease in Taiwan, 1996–2002

Two Men with Toxic Shock Syndrome Presenting with Targetoid and Spotty Skin Rashes

Menstruelles toxisches Schocksyndrom

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