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  • Title: Staphylococcal scalded skin syndrome and toxic shock syndrome after tooth extraction.
    Author: Brewer JD, Hundley MD, Meves A, Hargreaves J, McEvoy MT, Pittelkow MR.
    Journal: J Am Acad Dermatol; 2008 Aug; 59(2):342-6. PubMed ID: 18485528.
    Abstract:
    Staphylococcus aureus may cause cutaneous and systemic infections such as staphylococcal scalded skin syndrome (SSSS) and toxic shock syndrome (TSS). Although exfoliative toxins A and B, which cause SSSS, and TSS toxin-1 may be produced by different strains of S aureus, the two syndromes rarely occur simultaneously. We describe a patient admitted to the intensive care department with an exfoliative generalized erythroderma, signs of shock, and biopsy specimen findings consistent with SSSS. This patient presented after a tooth extraction. Symptoms recurred after dismissal, and he was readmitted. Subsequent test results were positive for exfoliative toxin B and TSS toxin-1, suggesting concurrent SSSS and TSS. For patients with acute, exfoliative, generalized erythroderma, TSS and SSSS should be considered. Although rare, it is possible to see both syndromes present concurrently.
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