A neonate develops rapidly progressing cellulitis with bullae formation. Cultures grow Staphylococcus aureus that produces a serine protease cleaving desmoglein-1. The syndrome is:

• A Staphylococcal toxic shock syndrome
• B Streptococcal necrotizing fasciitis
• C Bullous impetigo localized to the site of infection
• D Staphylococcal scalded skin syndrome (SSSS) ✓

Explanation

SSSS is caused by exfoliative toxins A and B (serine proteases) that cleave desmoglein-1 in the stratum granulosum, causing widespread superficial blistering and skin peeling; the bacterium is often at a remote site (umbilicus, conjunctiva). In bullous impetigo the toxin acts locally at the infection site. Toxic shock syndrome involves TSST-1 acting as a superantigen causing fever, hypotension, and multi-organ failure without skin cleavage. Necrotizing fasciitis is streptococcal deep tissue infection.

Reference: Ananthanarayan & Paniker's Textbook of Microbiology, 11th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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