Wednesday, November 7, 2012

Staphylococcal Enterotoxin B Toxic Shock Syndrome Induced by Community-acquired Methicillin-resistant Staphylococcus aureus (CA-MRSA).

Staphylococcal Enterotoxin B Toxic Shock Syndrome Induced by Community-acquired Methicillin-resistant Staphylococcus aureus (CA-MRSA).



Internal Medicine, Department of Pulmonary Medicine/Infection and Oncology, Nippon Medical School, Japan.


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.