Acute Staphylococcal Enteritis observed during the Course of Therapy with Broad-Spectrum Antibiotics
Ist Report: Clinical and bacteriological observations
1958 Volume 32 Issue 7 Pages 450-468
Details
1958 Volume 32 Issue 7 Pages 450-468
Fifty nine cases of acute staphyloccocal enteritis were found during the course of therapy with broad-spectrum antibiotics against bacillary dysentery from April 1954 to October 1955. Of these cases two were fatal of which one demonstrated pathologically pseudomembranous enteritis.
The broader the spectrum of antibiotics employed was and the younger the children treated were, the higher was the incidence of staphylococcal enteritis. Initial symptoms such as pharyngeal redness, diarrhea and fever were observed in general in 4 to 5 days after the initiation of therapy. Main signs and symptoms found during the course of this disorder were as follows: Fever (96.8%), pharyngeal redness (91.5%), diarrhea (91.5%), strawberry tongue (94.7%), rash (81.4%), abdominal pain (73.6%), sore throat (58.1%), nausea (55.9%), vomiting (52.5%) and relapse with re-exanthem (18.6%). Rash and relapse accompanied with re-exanthema were characteristic of this disease. Scarlatiniform exanthema appeared on the 2nd to 3rd day of illness, continuing for 3 to 7 days in 40 cases except 9 cases without exanthema and 10 cases with erythema-like rash.
The re-exanthema, erythema-like, urticaria-like or scarlatiniform, was observed in the: 3rd to 4th week of illness in 6 cases and the relapse with enteritic syndrom such as diarrhea, vomiting and fever about the 2nd week in 4 cases, both types presenting rather mild conditions. Furthermore, one case of mixed type was noted.
Hemolytic and coagulase positive staphylococci were always isolated from the throat, vomit and feces in the acute stage, showing high resistance to the antibiotics employed. The phage patterns of the staphylococci isolated were mainly 52/155/156 in 46 cases from April 1954 to December 1955, whereas 13 cases from February to October 1956 demonstrated all 42B/29, suggesting that these cases of staphylococcal enteritis were caused by cross-infection in the hospital.
