Staphylogenic scarlet fever A48.3

Dukes 1900; Stevens 1927

Rare infectious skin disease caused by the staphylococcal toxins SEB, SEA, SEG, SEI, TSST-1 (toxic shock syndrome toxin 1) (see exfoliatins below)

The disease has been described in connection with otitis media or purulent pharyngitis (Mun SJ et al. 2019; Andrey DO et al. 2015; Lu YC et al. 2011). Furthermore, staphylogenic infections after insect bites, after intra-articular injections or bursitis can be causative.

Affected are mainly children with an age peak around the age of 3 years. Only rarely are adults affected (Mun SJ et al. 2019)

Maculopapular exanthema. No enanthema (!). No blistering or exfoliation. Skin lesions are morphologically indistinguishable from a scarlet exanthema. Not infrequently multiple small abscesses of the skin can occur.

Staphylogenic scarlet fever (SSF), also known as non-menstrual staphylogenic toxin shock syndrome, differs from staphylogenic toxin shock syndrome (STSS) in that it is caused by a variety of very different factors. TSST-1 is the triggering erythrogenic toxin in only 50% of cases.

The disease is considered a (non-menstrual) minus variant of STSS (Godoy Gijón E et al. 2010).

1. Andrey DO et al (2015) Unusual staphylococcal toxic shock syndrome presenting as a scarlet-like fever. New Microbes New Infect 8:10-13.
2. Feldman CA (1962) Staphylococcal scarlet fever. N Engl J Med 267:877-878.
3. Godoy Gijón E et al. (2010) Scarlet fever variant of staphylococcal scalded skin syndrome.An Pediatr (Barc) 72:434-435.
4. Lu YC et al (2011) Scarlet fever caused by community-associated methicillin-resistant Staphylococcus aureus. Indian Pediatrics 48:563-565.
5. Mun SJ et al (2019) Staphylococcal scarlet fever associated with staphylococcal enterotoxin M in an elderly patient.Int J Infect Dis 85:7-9.