Symptoms of staphylococcal infection

Staphylococcal infection has an incubation period that usually lasts from 4 to 16 days, in food poisoning of staphylococcal etiology - 2-4 hours, sometimes reduced to 30 minutes and rarely increased to 6 hours, in toxic shock syndrome - from 12 to 48 hours, in other forms, including wound, eye and CNS infections - from 48 to 72 hours, in newborns - up to 4-5 days, in premature babies - up to 3 weeks, after which symptoms of staphylococcal infection appear. Staphylococcal infection does not have a generally accepted classification.

It is advisable to differentiate between local staphylococcal infection (indicating the localization), generalized staphylococcal infection and staphylococcal intoxication.

• Localized (local) staph infection:
  • skin and soft tissues (furuncle, pyoderma, abscess, phlegmon, hidradenitis);
  • ENT organs (tonsillitis, otitis, sinusitis);
  • organ of vision (barley, meibomitis, dacryocystitis);
  • genitourinary organs (pyelonephritis, cystitis);
  • arthritis, osteomyelitis;
  • colitis, enterocolitis.
• Generalized staph infection:
  • sepsis;
  • pneumonia, pleurisy;
  • endocarditis;
  • meningitis, brain abscess.
• Staphylococcal intoxications:
  • staph food poisoning;
  • staphylococcal scalded syndrome, including Ritter disease;
• Toxic shock syndrome.

Toxic shock syndrome was described in 1978 in women using vaginal tampons made of synthetic cotton wool, which is a favorable environment for the reproduction of staphylococcus, which produces a special toxin - toxic shock syndrome toxin (TSST). The development of toxic shock syndrome is possible when tamponing wounds, nasal passages, with localized pathological processes that are caused by strains of Staphylococcus aureus producing TSST. Toxic shock syndrome is characterized by a sudden onset, severe chills, hyperthermia, headache, myalgia, nausea and vomiting, diarrhea, sore throat. Diffuse hyperemia of the skin, abundant spotted, maculopapular, petechial rash with subsequent peeling of the skin are characteristic. Diffuse hyperemia of the mucous membrane of the oropharynx, tongue, and conjunctival injection are noted. Symptoms of staphylococcal infection are caused by a marked drop in blood pressure, the development of adult RDS, acute renal failure, and liver damage. Neutrophilic hyperleukocytosis with a left shift in the leukocyte formula and an increase in ESR are noted in the blood.

Staphylococci cause disease by direct tissue invasion. Staphylococcal infection is also sometimes caused by exotoxin production. Staphylococcus aureus bacteremia (often accompanied by the formation of metastatic foci of infection) may arise from any localized staphylococcal focus, but is especially common from an infected intravascular catheter or other foreign body. It may also arise without an apparent primary focus of infection. Staphylococcus epidermidis and other coagulase-negative staphylococci are increasingly causing hospital-acquired bacteremia associated with catheters and other foreign bodies. It is an important cause of morbidity (especially prolongation of hospital stay) and mortality in debilitated patients.

Direct invasion

Skin infections are the most common form of staphylococcal diseases. Superficial infections can be diffuse with the formation of vesicles, pustules, impetigo and sometimes cellulitis. They can also be focal and nodular (furuncles, carbuncles). Deep skin abscess is common. Staphylococci often join in wound and burn infections, suppuration of postoperative sutures, mastitis or breast abscess in nursing mothers.

Neonatal staphylococcal infection usually appears within 6 weeks of birth and involves skin lesions that may be accompanied by exfoliation, bacteremia, pneumonia, and meningitis.

Pneumonia may develop with influenza in patients receiving glucocorticoids or immunosuppressants, as well as in individuals with chronic bronchopulmonary pathology and other diseases that contribute to the development of pneumonia. However, Staphylococcus aureus is often the cause of hospital-acquired pneumonia. Staphylococcal pneumonia is characterized by the formation of pulmonary abscesses, accompanied by the rapid development of pneumatocelles and pleural empyema.

Endocarditis occurs more commonly in intravenous drug users and in patients with prosthetic valves. It is an acute febrile illness often associated with abscesses, emboli, pericarditis, subungual petechiae, subconjunctival hemorrhages, purpura, heart murmurs, and valvular heart failure.

Osteomyelitis most often occurs in children, causing cold-like symptoms, fever, and pain over the affected bone. Redness and swelling of the area follow. Periarticular infection is often accompanied by fluid accumulation in the joint cavity, so it appears more like septic arthritis than osteomyelitis.

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Diseases caused by the production of toxins

Staphylococci can produce multiple toxins. Some have a local effect, while others trigger the release of histamine by certain T cells, which in turn leads to serious systemic consequences, including skin damage, shock, multiple organ failure, and death.

Infectious toxic shock may be a consequence of the use of vaginal tampons or occur as a complication of postoperative suture infection.

Staphylococcal scalded skin syndrome is caused by several toxins called exfoliants. This condition is an exfoliative dermatitis of childhood and is characterized by the formation of large bullae and keratinization of the superficial layers of the skin. The result is exfoliation (peeling off) of the skin.

Staphylococcal food poisoning occurs when a prepared, heat-stable staphylococcal enterotoxin is consumed. Food may be contaminated by staphylococcal carriers or by people with an active skin infection. Staphylococci produce and release enterotoxin in undercooked food or food left at room temperature. Many foods can support staphylococci but retain their normal taste and smell despite contamination. Acute nausea and vomiting occur 2-8 hours after ingestion of contaminated food. Nausea and vomiting are usually followed by abdominal cramps and diarrhea. Symptoms of staph infection do not last long and usually end in less than 12 hours from the onset of the disease.

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