Korean J Dermatol.  2021 Jul;59(6):491-494.

A Case of Methicillin-Sensitive Staphylococcus aureus Bacteremia Superimposed on Eczema Herpeticum in a Patient with Uncontrolled Atopic Dermatitis

• Lee YS
• Kim YS
• Lee JH
• Choi JE
• Han TY

Abstract

Eczema herpeticum is a widespread herpes simplex infection that favors eczema-damaged skin, including skin involved with atopic dermatitis. Here we report a case of a 27-year-old woman who presented with febrile, painful, punched-out, erosive, macular eruptions and crusts on her face, upper trunk, and antecubital fossae. Polymerase chain reaction analyses of the blood and skin lesions were positive for type 1 herpes simplex virus, and blood cultures established on admission showed methicillin-sensitive Staphylococcus aureus. She was diagnosed with bacteremia superimposed on eczema herpeticum. True bacteremia rather than contaminated blood cultures was suspected because her fever did not improve after 2 days despite the administration of antivirals. Repeated scratches to the lesional skin most likely aggravated the epidermal barrier damage, enabling the penetration of the dermal vessels by colonized S. aureus.

Keyword

Atopic dermatitis; Bacteremia; Eczema herpeticum; Staphylococcus aureus