From the Guidelines
Methicillin-sensitive Staphylococcus aureus (MSSA) infections are commonly associated with skin rashes such as folliculitis, furuncles (boils), carbuncles, cellulitis, and abscesses. These rashes typically appear as red, swollen areas that may be painful, warm to the touch, and sometimes filled with pus.
- Impetigo presents as honey-colored crusted lesions,
- folliculitis shows small, red, pus-filled bumps around hair follicles,
- furuncles are deeper, more painful nodules that form when folliculitis progresses,
- carbuncles are clusters of connected furuncles,
- cellulitis appears as a spreading area of redness, warmth, and swelling. MSSA can also cause scalded skin syndrome in children, which presents as widespread redness followed by blistering and peeling, resembling a burn. Treatment typically involves antibiotics effective against MSSA, such as dicloxacillin 500mg four times daily for 7-10 days, cephalexin 500mg four times daily for 7-10 days, or clindamycin 300-450mg three times daily for 7-10 days, as recommended by the Infectious Diseases Society of America 1. Incision and drainage may be necessary for abscesses. These rashes occur because MSSA produces various toxins and enzymes that damage skin tissues and trigger inflammatory responses. According to a study published in the Clinical Infectious Diseases journal in 2005, MSSA infections can cause outbreaks of furunculosis, especially in settings involving close personal contact, and control of these outbreaks may require bathing with antibacterial soaps, thorough laundering of clothing, and attempted eradication of staphylococcal carriage among colonized persons 1. More recent guidelines from 2021 suggest that short-course antibiotics may be appropriate for common infections, including skin and soft tissue infections caused by MSSA, but emphasize the importance of considering the individual circumstances and potential for antibiotic resistance 1. Overall, the management of MSSA infections requires a comprehensive approach that includes antibiotic therapy, wound care, and prevention of further outbreaks.
From the Research
Types of Rashes Associated with MSSA Infections
- Impetigo: a superficial skin infection that can be caused by MSSA 2
- Folliculitis: an infection of the hair follicles that can be caused by MSSA 3
- Furuncles: a type of skin infection that can be caused by MSSA 3
- Cellulitis: a bacterial skin infection that can be caused by MSSA 4, 2
- Pyodermas: a type of skin infection that can be caused by MSSA 4
Characteristics of MSSA Infections
- MSSA infections can range from superficial to deep and potentially life-threatening 4
- The severity of the infection determines the choice of treatment 4
- Beta-lactam antibiotics are the mainstay of treatment for MSSA infections 4, 2
Treatment of MSSA Infections
- Oral beta-lactams, such as dicloxacillin and cephalexin, can be used to treat uncomplicated MSSA infections 2
- Other antibiotics, such as clindamycin and trimethoprim-sulfamethoxazole, can also be effective against MSSA 2, 3
- The choice of antibiotic should be guided by local susceptibility patterns and the severity of the infection 4, 2