Staphylococcal enterotoxins G and I, a cause of severe but reversible neonatal enteropathy.

Staphylococcal enterotoxins G and I, a cause of severe but reversible neonatal enteropathy. Research Abstract Details 

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Staphylococcal enterotoxins G and I, a cause of severe but reversible neonatal enteropathy. Abstract Text:

Sandhia Naik,Fabienne Smith,John Ho,Nicholas M Croft,Paola Domizio,Elisabeth Price,Ian R Sanderson,Nigel J Meadows,Sandhia Naik,Fabienne Smith,John Ho,Nicholas M Croft,Paola Domizio,Elisabeth Price,Ian R Sanderson,Nigel J Meadows,

BACKGROUND & AIMS: Staphylococcus aureus is recognized to produce toxins A-E and toxic shock syndrome toxin-1 associated with food poisoning and toxic shock syndrome. Enterotoxins G and I co-exist in the same S aureus strains (staphylococcal enterotoxin G and staphylococcal enterotoxin I) and are implicated in scarlet fever and toxic shock. We report these enterotoxins as causative agents of 2 cases of neonatal intractable diarrhea with enteropathy. METHODS: We used a note review for this study. Stool culture, multiplex polymerase chain reaction for enterotoxin, duodenal biopsy specimens for H&E, periodic acid-Schiff staining, and electron microscopy were used. RESULTS: Infant 1 had diarrhea from age 2 weeks and was referred at age 5 weeks with weight less than the 0.4th percentile. Infant 2 was referred at age 7 weeks with 4 weeks' of diarrhea, weight less than the 0.4th percentile. Both infants were severely malnourished. Elemental feeds were not tolerated and total parenteral nutrition was required. S aureus producing staphylococcal enterotoxin G and staphylococcal enterotoxin I was isolated in stools from both infants. Clinical improvement occurred after intravenous flucloxacillin and parenteral nutrition. Histology showed subtotal villous atrophy (H&E) with abnormal brush border (periodic acid-Schiff). Electron microscopy showed severe microvilli destruction, dilated mitochondria, and lysosomes containing cellular debris. Repeat histology was normal in infant 2, age 3 months, off parenteral nutrition, showed return to normal. Currently, both infants are 2 years of age and are thriving on a normal diet. CONCLUSIONS: Staphylococcal enterotoxin G- and I-induced enteropathy is a life-threatening condition, causing reversible disruption of enterocyte ultrastructure that responds well to supportive treatment with flucloxacillin and parenteral nutrition This condition should be a differential diagnosis of neonatal early onset diarrhea.

Staphylococcal enterotoxins G and I, a cause of severe but reversible neonatal enteropathy. Publishing Authors By Initials

S Naik,F Smith,J Ho,NM Croft,P Domizio,E Price,IR Sanderson,NJ Meadows,S Naik,F Smith,J Ho,NM Croft,P Domizio,E Price,IR Sanderson,NJ Meadows,

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Staphylococcal enterotoxins G and I, a cause of severe but reversible neonatal enteropathy. Journal Published:

PUBLICATION TYPE: Journal Article

Journal: Clinical gastroenterology and hepatology : the off

VOLUME: 6

Page Numbers: 251-4

Journal Abbreviation: Clin. Gastroenterol. Hepatol.

ISSN: 1542-7714

DAY: 11

MONTH: 12

YEAR: 2007

Staphylococcal enterotoxins G and I, a cause of severe but reversible neonatal enteropathy. Information

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LANGUAGE: eng

NlmUniqueID: 101160775

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AFFILIATION: Department of Paediatric Gastroenterology, Barts and the London NHS Trust, London, United Kingdom. Sandhia.naik@bartsandthelondon.nhs.uk

Country: United States

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MEDLINETA: Clin Gastroenterol Hepatol

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