Toxic shock syndrome due to community-acquired methicillin-resistant Staphylococcus aureus infection: Two case reports and a literature review in Japan

Abstract

Community-acquired methicillin-resistant Staphylococcus aureus has been spreading worldwide, including in Japan. However, few cases of toxic shock syndrome caused by Community-acquired methicillin-resistant Staphylococcus aureus have been reported in Japan. We report 2 cases, in middle-aged women, of toxic shock syndrome due to Community-acquired methicillin-resistant Staphylococcus aureus via a vaginal portal of entry. The first patient had used a tampon and the second patient had vaginitis due to a cleft narrowing associated with vulvar lichen sclerosus. Both patients were admitted to our hospital with septic shock and severe acute kidney injury and subsequently recovered with appropriate antibiotic treatment. In our review of the literature, 8 cases of toxic shock syndrome caused by Community-acquired methicillin-resistant Staphylococcus aureus were reported in Japan. In these 8 cases, the main portals of entry were the skin and respiratory tract; however, the portal of entry of Community-acquired methicillin-resistant Staphylococcus aureus from a vaginal lesion has not been reported in Japan previously.

Disparate effects of methicillin-resistant Staphylococcus aureus infection on renal function in IgA-dominant infection-associated glomerulonephritis and menstrual toxic shock syndrome: a case report and literature review

“…The kidney is one of the most affected organs during multiple organ failure associated with sepsis, 29 and mTSS places renal function in dire jeopardy. 30 In an early report, full-swing acute renal failure was observed in all nine fatal cases of mTSS. 31 Unlike IgA-dominant infection-associated GN, S. aureus exotoxin rather than enterotoxin is responsible for mTSS and associated multiple organ failure.…”

SEC is an antiangiogenic virulence factor that promotes Staphylococcus aureus endocarditis independent of superantigen activity

“…IL-6 is a cytokine produced at high levels as a result of SAg activity ( 22 ). LDH, found in almost every cell in the body, is released into the systemic circulation as a result of tissue injury including the cytotoxic effects of cytokine storms ( 23 – 25 ). On average, both IL-6 and LDH levels in rabbits infected with S. aureus expressing toxoids were not significantly different from those in rabbits infected with S. aureus SEC KO ( Fig.…”

Molecular Typing of Community-acquired Methicillin-Resistant Staphylococcus aureus Isolated from 2- to 6-year old Children by Staphylococcal Protein A and Agr Typing in Isfahan, Iran

“…MRSA can produce many exotoxins such as TSST-1 and α-hemolysin which were associated with a severe illness that includes shock and multiple organ failure and is called toxic shock syndrome. [ 28 29 ] Approximately 20% and 5% of MRSA isolates possess the genes encoding TSST-1, and α-hemolysin, respectively. However, the result of the current study showed that 16 isolates (64%) and 4 isolates (16.6%) were positive for the TSST-1 and α-hemolysin gene, respectively.…”