Severe staphylococcal sepsis in adolescents

Abstract

During the three-year period beginning in early 1972, nine previously healthy children, ages 8 to 15 years, presented with manifestations of life-threatening septicemia due to coagulase-positive Staphylococcus aureus. In no patient was a predisposing cause for such infection, such as immunologic deficiency, drug abuse, or previous antibiotic or immunosuppressant therapy, discovered. Seven patients manifested evidence of bone and/or joint infection, while eight had pulmonary disease of varying degrees of severity, characterized initially by multiple small septic pulmonary emboli. One patient succumbed to the pulmonary complications of her disease. S. aureus was recovered from specimens of blood (seven patients), joint fluid (four), bone (four), pleural fluid (two), urine (one), sputum (one), and pericardial fluid (one). All organism isolated were methicillin-sensitive; isolates from only one patient were penicillin-sensitive. In several instances, lack of clinical response was related to delay in adequate surgical drainage of infected material. Review of hospital records for the preceding five-year period failed to reveal similar cases of severe systemic staphylococcal infection in healthy adolescents. Although no direct evidence for a causal relationship is available, the occurrence of these cases corresponds temporally with implementation of restrictions upon the use of hexachlorophene.