tailieunhanh - Chapter 129. Staphylococcal Infections (Part 9)

Food Poisoning S. aureus is among the most common causes of food-borne outbreaks of infection in the United States. S. aureus food poisoning results from the inoculation of toxin-producing S. aureus into food by colonized food handlers. Toxin is then elaborated in such growth-promoting food as custards, potato salad, or processed meats. Even if the bacteria are killed by warming, the heat-stable toxin is not destroyed. The onset of illness is rapid, occurring within 1–6 h of ingestion. The illness is characterized by nausea and vomiting, although diarrhea, hypotension, and dehydration may also occur. The differential diagnosis includes diarrhea of. | Chapter 129. Staphylococcal Infections Part 9 Food Poisoning S. aureus is among the most common causes of food-borne outbreaks of infection in the United States. S. aureus food poisoning results from the inoculation of toxin-producing S. aureus into food by colonized food handlers. Toxin is then elaborated in such growth-promoting food as custards potato salad or processed meats. Even if the bacteria are killed by warming the heat-stable toxin is not destroyed. The onset of illness is rapid occurring within 1-6 h of ingestion. The illness is characterized by nausea and vomiting although diarrhea hypotension and dehydration may also occur. The differential diagnosis includes diarrhea of other etiologies especially that caused by similar toxins . the toxins elaborated by Bacillus cereus . The rapidity of onset the absence of fever and the epidemic nature of the presentation arouse suspicion of food poisoning. Symptoms generally resolve within 8-10 h. The diagnosis can be established by the demonstration of bacteria or the documentation of enterotoxin in the implicated food. Treatment is entirely supportive. Staphylococcal Scalded-Skin Syndrome SSSS most often affects newborns and children. The illness may vary from localized blister formation to exfoliation of much of the skin surface. The skin is usually fragile and often tender with thin-walled fluid-filled bullae. Gentle pressure results in rupture of the lesions leaving denuded underlying skin Nikolsky s sign Fig. 129-4 . The mucous membranes are usually spared. In more generalized infection there are often constitutional symptoms including fever lethargy and irritability with poor feeding. Significant amounts of fluid can be lost in more extensive cases. Illness usually follows localized infection at one of a number of possible sites. SSSS is much less common among adults but can follow infections caused by exfoliative toxin-producing strains. Prevention Prevention of the spread of S. aureus infections in the