Key result
Flow cytometric analysis confirmed the activation of SEB-reactive Vβ3+ and Vβ12+ T cells in a patient with pandemic H1N1 influenza and CA-MRSA coinfection who developed toxic shock syndrome.
Case Report (n=1)
No
This case provides the first immunological confirmation of Staphylococcal enterotoxin B contributing directly to toxic shock syndrome in a patient with CA-MRSA and pH1N1 influenza.
Suggests SEB-mediated TSS in pH1N1 with CA-MRSA; hypothesis-generating and requires validation before clinical consideration.
We herein report a case of toxic shock syndrome (TSS) associated with the 2009 pandemic H1N1 (pH1N1) influenza virus and a community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infection in a 16-year-old Vietnamese girl. Staphylococcal enterotoxin B (SEB) was detected in the patient's serum, and the level of anti-SEB antibodies was found to be elevated. A flow cytometric analysis showed evidence of activated SEB-reactive Vβ3+ and Vβ12+ T cells. These data suggest that the CA-MRSA-induced activation of SEB-reactive T cells may cause TSS in patients with pH1N1 virus infection. Moreover, this is the first report describing immunological confirmation of SEB contributing directly to TSS in a patient fulfilling the diagnostic criteria of TSS.
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Kashiwada et al. (2012) conducted a case report in Toxic Shock Syndrome (TSS) associated with pH1N1 influenza and CA-MRSA (n=1). Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) producing Staphylococcal enterotoxin B (SEB) was evaluated on Activation of SEB-reactive T cells (Vβ3+ and Vβ12+). Flow cytometric analysis confirmed the activation of SEB-reactive Vβ3+ and Vβ12+ T cells in a patient with pandemic H1N1 influenza and CA-MRSA coinfection who developed toxic shock syndrome.
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