Staphylococcal Infections Clinical Presentation

Updated: Jun 12, 2019
  • Author: Thomas E Herchline, MD; Chief Editor: Mark R Wallace, MD, FACP, FIDSA  more...
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Presentation

History

Common manifestations of staphylococcal infections include the following types of infections. The history obtained usually depends on the type of infection the organism causes.

  • Skin infections (Many individuals who present with community-acquired skin infections are initially misdiagnosed with spider bites. These infections are often due to methicillin-resistant S aureus [MRSA].)

  • Soft-tissue infections (pyomyositis, septic bursitis, septic arthritis)

  • Toxic shock syndrome

  • Endocarditis

  • Osteomyelitis

  • Staphylococcal infections of prosthetic devices, including prosthetic joints and heart valves and vascular shunts, grafts, and catheters (these are increasing in incidence, mostly likely because of the increase in staphylococcal line-related bacteremias [18, 19] )
  • Urinary tract infection

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Physical

See the list below:

  • Skin and soft-tissue infections

    • Erythema

    • Warmth

    • Draining sinus tracts

    • Superficial abscesses

    • Bullous impetigo

  • Toxic shock syndrome

    • Fever greater than 38.9°C

    • Diffuse erythroderma - Deep, red, "sunburned" appearance

    • Hypotension

    • Desquamation - Occurs 7-14 days after onset of illness, usually involves palms and soles

  • Endocarditis

    • Regurgitant murmur

    • Petechiae or other cutaneous lesions

      Embolic lesions in patient with Staphylococcus aur Embolic lesions in patient with Staphylococcus aureus endocarditis.
      Close-up view of embolic lesions in patient with S Close-up view of embolic lesions in patient with Staphylococcus aureus endocarditis.
    • Fever

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Causes

Predisposing factors for staphylococcal infections include the following:

  • Neutropenia or neutrophil dysfunction

  • Diabetes

  • Intravenous drug abuse

  • Foreign bodies, including intravascular catheters

Colonization with S aureus is common. Skin-to-skin and skin-to-fomite contact are common routes of acquisition. [20] Isolates can be spread by coughing or sneezing. [21] Evidence has also shown that S aureus can be spread during male homosexual sex. [22] Pets can also serve as household reservoirs. [23] The rate of MRSA hand colonization among health care workers has been shown to exceed 4% (over 8% in North America). [13]

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