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Acute Disseminated Staphylococcal Disease in Childhood

Acute Disseminated Staphylococcal Disease in Childhood Abstract • From 1964 to 1974 we treated 15 children who had acute disseminated staphylococcal disease. The majority were previously-well males over 5 years of age. Thirteen of 15 patients had one or more cutaneous lesions characteristic of staphylococcal septicemia. Fifty percent of extracutaneous foci of staphylococcal infection were not detected on hospital admission and one third of these lesions were noted for the first time at autopsy. An absolute polymorphonuclear cell count of greater than 10,000/cu mm or an absolute band-form count of greater than 500/cu mm, or both, correlated with the presence of one or more inadequately treated sites of infection. These foci were responsible for bacteremia continuing after the initiation of antimicrobial therapy and for prolonged fever. The overall mortality was 27%; three of the four deaths occurred in patients with predisposing medical conditions. In addition to prolonged antimicrobial therapy, all patients should be evaluated carefully for the presence of occult metastatic sites of staphylococcal infection. (Am J Dis Child 131:181-185, 1977) References 1. Bashinsky L: Unusual fulminating generalized staphylococcus infections treated with penicillin . J Pediatr 27:428-452, 1945.Crossref 2. Anderson WW, Cathcart DF: Primary staphylococcic pneumonia complicated by empyema, septicemia, multiple abscesses and osteomyelitis of the skull and second metacarpal bone of the right hand, with recovery . Am J Dis Child 49:1276-1281, 1935.Crossref 3. Coles H: Staphylococcal sepsis with pulmonary and cold subcutaneous abscesses . Arch Dis Child 25:280-291, 1950.Crossref 4. Blogg H, Connor C, Newman W, et al: Prolonged staphylococcemia . N Engl J Med 252:185-187, 1955.Crossref 5. Cabot Case #14301: Cough, fever and dyspnea fatal in three days . N Engl J Med 199:535-536, 1928.Crossref 6. Cabot Case #14101: Epigastric pain, vomiting and delirium . N Engl J Med 198:518-520, 1928.Crossref 7. Bowler J, Boardman J: Staphylococcus septicemia with metastatic osteomyelitis . N Engl J Med 200:327-329, 1929.Crossref 8. Henderson F: Staphylococcal bacteremia with endocarditis, meningitis and septic emboli . J Germantown Hosp 2:87-92, 1961. 9. Finkelstein J, Glotzer S: Overwhelming staphylococcal septicemia . Med Times 90:533-538, 1962. 10. Clinicopathologic Conference: A 38-year-old woman with overwhelming sepsis . Am J Med 53:233-241, 1972.Crossref 11. Kassanoff I, Nahmias A, Abrutyn E: Fatal staphylococcal septicemia associated with use of jet injector for measles vaccination . Pediatrics 47:135-137, 1971. 12. Benazet A: Illustrative cases of staphylococcia in paediatric practice . Int Clin 4:238-256, 1920. 13. Cabot case 24492 : N Engl J Med 219:926-928, 1938.Crossref 14. Shulman T, Felman A, Ayoub E: Severe staphylococcal sepsis in adolescents, abstracted . Pediatr Res 9:344, 1975. 15. Mendell T: Staphylococci septicemia . Arch Int Med 63:1068-1083, 1939.Crossref 16. Skinner D, Keefer C: Significance of bacteremia caused by Staphylococcus aureus . Arch Int Med 68:851-875, 1941.Crossref 17. MacNeal W, Frisbee F, McRae M: Staphylococcemia 1931-1940-500 cases . Am J Clin Pathol 12:281-294, 1942. 18. Collins H, Helper A, Blevins A, et al: Staphylococcal bacteremia . Ann NY Acad Sci 65:222-234, 1956.Crossref 19. Wilson R, Hamburger M: Fifteen years experience with staphylococcus septicemia in a large hospital . Am J Med 22:437-457, 1957.Crossref 20. Ying T, et al: Staphylococcal septicemia . Chin Med J 75:217-232, 1957. 21. Rogers D: Staphylococcal infections . DM , (April) 1958, pp; 2-44. 22. Hassall J, Rountree P: Staphylococcal septicemia . Lancet 1:213-217, 1959.Crossref 23. Hay D: Staphylococcal septicemia and pyaemia . Q J Med 29(n.s.):313-331, 1960. 24. Holloway W, Scott E: Staphylococcal septicemia . Del State Med J 31:198-203, 1959. 25. Kirby W, Perry D, Bauer A: Treatment of staphylococcal septicemia with vancomycin . N Engl J Med 262:49-55, 1960.Crossref 26. Currey H: Staphylococcal septicaemia and pyaemia . S Afr Med J 36:1072-1077, 1962. 27. Allen J, Roberts E, Kirby W: Staphylococcal septicemia treated with methicillin . N Engl J. Med 266:111-116, 1962.Crossref 28. Jensen K, Lassen H: Fulminating staphylococcal infections treated with ducidin and penicillin . Ann Int Med 60:790-798, 1964.Crossref 29. Kucers A, Bennet N: Staphylococcal septicemia . Med J Aust 1:217-222, 1964. 30. Johnston R, Sell S: Septicemia in infants and children . Pediatrics 34:473-479, 1964. 31. Fischer M, McArtor R: Staphylococcal septicemia . Ohio State Med J 42:1325-1327, 1967. 32. Cluff L, Reynolds R: Management of staphylococcal infections . Am J Med 39:812-825, 1965.Crossref 33. Cluff L, Reynolds R, Page D, et al: Staphylococcal bacteremia: Demographic, clinical and microbiologic features of 185 cases . Trans Am Clin Climatol Assoc 79:205-215, 1968. 34. Jessen O, Rosendal K, Bulow P, et al: Changing staphylococci and staphylococcal infections . N Engl J Med 281:627-635, 1969.Crossref 35. Gilbert D, Sanford J: Methicillin: Critical appraisal after a decade of experience . Med Clin N Am 54:1113-1125, 1970. 36. Hall W: Sepsis revisited . J Maine Med Assoc 62:91-100, 1971. 37. Mier K: Die Klinik der Staphylokokkensepsis . Schweiz Med Wochenschr 102:1745-1750, 1972. 38. Wise R: Modern management of severe staphylococcal disease . Medicine 52:295-304, 1973.Crossref 39. Austin T, Wallace J: Staphylococcus aureus bacteremia: A critical review of its treatment and association with endocarditis . Infection 1:214-217, 1973.Crossref 40. Trinh-Thi-Minh-Ha, Phan-Nguc-Thanh, Tran-Ngoc-Ba, et al: A purpose de l'infection staphylococcique ches le nourrison Vietnamien . Acta Med Vietnamica 19:49-58, 1974. 41. Rogers D: Staphylococci and man . JAMA 181:38-40, 1962.Crossref 42. Plaut M: Staphylococcal septicemia and pustular purpura . Arch Dermatol 99:82-85, 1969.Crossref 43. Todd JK: Childhood infections: Diagnostic value of peripheral white blood cell counts and differential cell counts . Am J Dis Child 127:810-816, 1974.Crossref 44. Powell D: Non-suppurative lesions in staphylococcal septicemia . J Pathol Bacteriol 82:141-149, 1961.Crossref 45. Wallmark G, Finland M: Phage types and antibiotic susceptibility of pathogenic staphylococci: Results at Boston City Hospital 1959-1960 and comparisons with strains of previous years . JAMA 175:886, 1961.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Diseases of Children American Medical Association

Acute Disseminated Staphylococcal Disease in Childhood

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Publisher
American Medical Association
Copyright
Copyright © 1977 American Medical Association. All Rights Reserved.
ISSN
0002-922X
DOI
10.1001/archpedi.1977.02120150063012
Publisher site
See Article on Publisher Site

Abstract

Abstract • From 1964 to 1974 we treated 15 children who had acute disseminated staphylococcal disease. The majority were previously-well males over 5 years of age. Thirteen of 15 patients had one or more cutaneous lesions characteristic of staphylococcal septicemia. Fifty percent of extracutaneous foci of staphylococcal infection were not detected on hospital admission and one third of these lesions were noted for the first time at autopsy. An absolute polymorphonuclear cell count of greater than 10,000/cu mm or an absolute band-form count of greater than 500/cu mm, or both, correlated with the presence of one or more inadequately treated sites of infection. These foci were responsible for bacteremia continuing after the initiation of antimicrobial therapy and for prolonged fever. The overall mortality was 27%; three of the four deaths occurred in patients with predisposing medical conditions. In addition to prolonged antimicrobial therapy, all patients should be evaluated carefully for the presence of occult metastatic sites of staphylococcal infection. (Am J Dis Child 131:181-185, 1977) References 1. Bashinsky L: Unusual fulminating generalized staphylococcus infections treated with penicillin . J Pediatr 27:428-452, 1945.Crossref 2. Anderson WW, Cathcart DF: Primary staphylococcic pneumonia complicated by empyema, septicemia, multiple abscesses and osteomyelitis of the skull and second metacarpal bone of the right hand, with recovery . Am J Dis Child 49:1276-1281, 1935.Crossref 3. Coles H: Staphylococcal sepsis with pulmonary and cold subcutaneous abscesses . Arch Dis Child 25:280-291, 1950.Crossref 4. Blogg H, Connor C, Newman W, et al: Prolonged staphylococcemia . N Engl J Med 252:185-187, 1955.Crossref 5. Cabot Case #14301: Cough, fever and dyspnea fatal in three days . N Engl J Med 199:535-536, 1928.Crossref 6. Cabot Case #14101: Epigastric pain, vomiting and delirium . N Engl J Med 198:518-520, 1928.Crossref 7. Bowler J, Boardman J: Staphylococcus septicemia with metastatic osteomyelitis . N Engl J Med 200:327-329, 1929.Crossref 8. Henderson F: Staphylococcal bacteremia with endocarditis, meningitis and septic emboli . J Germantown Hosp 2:87-92, 1961. 9. Finkelstein J, Glotzer S: Overwhelming staphylococcal septicemia . Med Times 90:533-538, 1962. 10. Clinicopathologic Conference: A 38-year-old woman with overwhelming sepsis . Am J Med 53:233-241, 1972.Crossref 11. Kassanoff I, Nahmias A, Abrutyn E: Fatal staphylococcal septicemia associated with use of jet injector for measles vaccination . Pediatrics 47:135-137, 1971. 12. Benazet A: Illustrative cases of staphylococcia in paediatric practice . Int Clin 4:238-256, 1920. 13. Cabot case 24492 : N Engl J Med 219:926-928, 1938.Crossref 14. Shulman T, Felman A, Ayoub E: Severe staphylococcal sepsis in adolescents, abstracted . Pediatr Res 9:344, 1975. 15. Mendell T: Staphylococci septicemia . Arch Int Med 63:1068-1083, 1939.Crossref 16. Skinner D, Keefer C: Significance of bacteremia caused by Staphylococcus aureus . Arch Int Med 68:851-875, 1941.Crossref 17. MacNeal W, Frisbee F, McRae M: Staphylococcemia 1931-1940-500 cases . Am J Clin Pathol 12:281-294, 1942. 18. Collins H, Helper A, Blevins A, et al: Staphylococcal bacteremia . Ann NY Acad Sci 65:222-234, 1956.Crossref 19. Wilson R, Hamburger M: Fifteen years experience with staphylococcus septicemia in a large hospital . Am J Med 22:437-457, 1957.Crossref 20. Ying T, et al: Staphylococcal septicemia . Chin Med J 75:217-232, 1957. 21. Rogers D: Staphylococcal infections . DM , (April) 1958, pp; 2-44. 22. Hassall J, Rountree P: Staphylococcal septicemia . Lancet 1:213-217, 1959.Crossref 23. Hay D: Staphylococcal septicemia and pyaemia . Q J Med 29(n.s.):313-331, 1960. 24. Holloway W, Scott E: Staphylococcal septicemia . Del State Med J 31:198-203, 1959. 25. Kirby W, Perry D, Bauer A: Treatment of staphylococcal septicemia with vancomycin . N Engl J Med 262:49-55, 1960.Crossref 26. Currey H: Staphylococcal septicaemia and pyaemia . S Afr Med J 36:1072-1077, 1962. 27. Allen J, Roberts E, Kirby W: Staphylococcal septicemia treated with methicillin . N Engl J. Med 266:111-116, 1962.Crossref 28. Jensen K, Lassen H: Fulminating staphylococcal infections treated with ducidin and penicillin . Ann Int Med 60:790-798, 1964.Crossref 29. Kucers A, Bennet N: Staphylococcal septicemia . Med J Aust 1:217-222, 1964. 30. Johnston R, Sell S: Septicemia in infants and children . Pediatrics 34:473-479, 1964. 31. Fischer M, McArtor R: Staphylococcal septicemia . Ohio State Med J 42:1325-1327, 1967. 32. Cluff L, Reynolds R: Management of staphylococcal infections . Am J Med 39:812-825, 1965.Crossref 33. Cluff L, Reynolds R, Page D, et al: Staphylococcal bacteremia: Demographic, clinical and microbiologic features of 185 cases . Trans Am Clin Climatol Assoc 79:205-215, 1968. 34. Jessen O, Rosendal K, Bulow P, et al: Changing staphylococci and staphylococcal infections . N Engl J Med 281:627-635, 1969.Crossref 35. Gilbert D, Sanford J: Methicillin: Critical appraisal after a decade of experience . Med Clin N Am 54:1113-1125, 1970. 36. Hall W: Sepsis revisited . J Maine Med Assoc 62:91-100, 1971. 37. Mier K: Die Klinik der Staphylokokkensepsis . Schweiz Med Wochenschr 102:1745-1750, 1972. 38. Wise R: Modern management of severe staphylococcal disease . Medicine 52:295-304, 1973.Crossref 39. Austin T, Wallace J: Staphylococcus aureus bacteremia: A critical review of its treatment and association with endocarditis . Infection 1:214-217, 1973.Crossref 40. Trinh-Thi-Minh-Ha, Phan-Nguc-Thanh, Tran-Ngoc-Ba, et al: A purpose de l'infection staphylococcique ches le nourrison Vietnamien . Acta Med Vietnamica 19:49-58, 1974. 41. Rogers D: Staphylococci and man . JAMA 181:38-40, 1962.Crossref 42. Plaut M: Staphylococcal septicemia and pustular purpura . Arch Dermatol 99:82-85, 1969.Crossref 43. Todd JK: Childhood infections: Diagnostic value of peripheral white blood cell counts and differential cell counts . Am J Dis Child 127:810-816, 1974.Crossref 44. Powell D: Non-suppurative lesions in staphylococcal septicemia . J Pathol Bacteriol 82:141-149, 1961.Crossref 45. Wallmark G, Finland M: Phage types and antibiotic susceptibility of pathogenic staphylococci: Results at Boston City Hospital 1959-1960 and comparisons with strains of previous years . JAMA 175:886, 1961.Crossref

Journal

American Journal of Diseases of ChildrenAmerican Medical Association

Published: Feb 1, 1977

References