CBRNE - Staphylococcal Enterotoxin B Treatment & Management

Updated: Dec 31, 2015
  • Author: Bruce A Gleason, MD; Chief Editor: Duane C Caneva, MD, MSc  more...
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Prehospital Care

Treatment of staphylococcal enterotoxin B illness is supportive.

  • In the event of dehydration, vigorous administration of intravenous fluids is indicated.

  • For patients exposed via inhalation, supportive treatment with humidified oxygen may be all that is necessary, although significant exposure may dictate intubation and assisted ventilation with high oxygen concentrations.

  • The efficacy of steroids in SEB-induced pulmonary edema or ARDS has not been demonstrated.


Emergency Department Care

Treatment of staphylococcal enterotoxin B (SEB) illness is limited to supportive care, with special attention to elimination of hypotension and hypoxia and pain control as needed. [1, 15]

  • Cough suppressants and acetaminophen for fever will make the patient more comfortable.

  • Antiemetics should be provided for nausea in food poisoning as necessary.

  • Mechanical ventilation may be required in severe cases.

  • Vasopressors and diuretics may be required in severe cases.

  • Antibiotics have not demonstrated efficacy in SEB intoxication, and steroids have not been shown to be effective in SEB-induced pulmonary edema.



Consultations are dictated by the patient's physiologic condition.

  • If a terrorist attack using staphylococcal enterotoxin B (SEB) is suspected, expeditiously inform local law enforcement personnel, including the local Federal Bureau of Investigation.

  • In the event that a cluster of patients present with similar symptoms, either of pulmonary or GI origin, notify local public health officials to begin epidemiologic investigation.