Skin Infection by Coagulase Negative Staphylococci as a Potential Triggering Factor for Cutaneous Leukocytoclastic Vasculitis

Abstract

Introduction: Leukocytoclastic vasculitis (LV) is a necrotising vasculitis of the small dermal blood vessels, clinically presented as palpable purpura. It is a heterogeneous disorder often limited to the skin but which may involve other organs. LV might be a serious drug reaction, caused by bacterial and viral infections, or less commonly a manifestation of systemic vasculitic syndromes.

Staphylococcal infections among leukemic patients

“…Isolation of S.aureus or S.epidermidis from the blood is a hazardous condition since a positive blood culture yielding S.epidermidis should always be considered partially hazardous in immunocompromised patients [13].To obtain pure culture and to role out the growth of the suspected contaminant of (CoNS) in blood cultures, the specimen were incubated up to 48h before reading the results since it has been mentioned by several workers [13,14,15] that pathogenic bacteria grow in a shorter time than contaminants in blood culture. The least of the isolated (CoNS) from which no isolates have been obtained include S.chromogenes ,S.xylusus and S.caprae from aspirated wound .Even if the rate of isolates of (CoNS) other than S.epidermidis from the other sites in this work is low, its pathogenic role is not excluded since it has been supported by others [16,17,19]who claimed that there are number of recent reports which states that (CoNS) are the most common pathogen in blood stream and urinary tract infection in immunocopmromised patients. Another important isolates in this study is S.aurues which rank the 2 nd 20 among the isolates a result which agree with other [20,21] It cannt be advised that Vancomycin is the drug of choice in infections caused by CoNS and CoPS due to it's a poteintial toxic drug and has long term side effect since it s very effective against staph infection by inhibiting synthesis of bacterial cell wall.…”

Infantile leukocytoclastic vasculitis caused by enterotoxin‐producing methicillin‐sensitive Staphylococcus aureus

“…1,2 Several reports describe bacteremia in cases of LCV associated with staphylococcal and other bacterial infections. 2,[7][8][9] In these reports, blood culture tests are positive, suggesting that the infection-causing bacteria are abundant in the blood and cause further inflammation. [7][8][9] In our case, the blood culture test was negative but S. aureus enterotoxins A and C were positive, which could have caused excessive immune system activation and further inflammation.…”

“…Staphylococcal infection has been reported as one of the causes of LCV. [7][8][9] Pathogenic strains of S. aureus are known to produce pyrogenic toxin superantigens, such as TSST-1 and staphylococcal enterotoxins (SE), that cause excessive antibody production. 3,10 In particular, SE can stimulate human T cells to secrete interleukin-2 and tumor necrosis factorα, causing a systemic cytokine storm that can lead to immune-mediated vasculitis.…”

“…In LCV, bacterial antigens and host‐produced antibodies form an immune complex that is deposited on the walls of blood vessels and result in the excessive activation of the host's immune system 1,2 . Several reports describe bacteremia in cases of LCV associated with staphylococcal and other bacterial infections 2,7‐9 . In these reports, blood culture tests are positive, suggesting that the infection‐causing bacteria are abundant in the blood and cause further inflammation 7‐9 .…”

“…Staphylococcal infection has been reported as one of the causes of LCV 7‐9 . Pathogenic strains of S. aureus are known to produce pyrogenic toxin superantigens, such as TSST‐1 and staphylococcal enterotoxins (SE), that cause excessive antibody production 3,10 .…”