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Introduction: Spiders, especially those of the genus Loxoceles such as L. rufescens, endemic in Mediterranean regions, are frequently reported as causes of venom poisoning in humans in the south of France. The most common signs consist of cutaneous necrosis presenting initially as inflammatory cellulitis and progressing towards the emergence of a necrotic centre., Patients and Methods: We report 4 cases, initially considered as spider bites due to their sudden occurrence and pain. Rigorous clinical examination coupled with collection of samples for laboratory analysis ultimately enabled the diagnosis to be corrected to one of suppurative skin infection caused by Staphylococcusaureus producing the cytotoxin Panton Valentine leucocidin., Discussion: These observations highlight the potential for confusion between spider bites and infections with PVL-producing S. aureus., (Copyright © 2019 Elsevier Masson SAS. All rights reserved.)

Background: Herein we report a case of cutaneous granular bacteriosis, with discussion of the nosological setting of this entity based upon the clinical and histological findings., Patients and Methods: A 62-year-old woman receiving methotrexate for Sezary syndrome was admitted for fever of 38.5̊C and overall impairment of her health. She presented a fistulous nodule on her right knee, and skin biopsy revealed a focus of ulcerated suppuration with quantities of Gram+ and Grocott+ granules containing no filament, enclosed by eosinophilic matter (Splendore-Hoeppli phenomenon). A sample of effusion from the sole of her right foot revealed a methicillin-sensitive strain of Staphylococcus aureus, which was also found in several blood cultures. Two abscessed nodules on the middle right lobe were visible on a thoracic CT scan despite the initial absence of respiratory symptoms. In view of this bacteraemia of cutaneous origin with sepsis caused by methicillin-sensitive S. aureus complicated by pulmonary abscesses, dual antibiotic treatment against staphylococci (cloxacillin-gentamicin followed by rifampicin-ofloxacin) was given over a two-month period., Discussion: The histological picture of granular bacteriosis suggested the possibility of botryomycosis or mycetoma. Botryomycosis involves chronic, relapsing, weeping and ulcero-vegetating abscesses. Mycetoma consists of fistulous swellings that secrete a discharge composed of blood and serum and containing grains made up of filaments. Although the staphylococcal organism identified was evocative of botryomycosis, the clinical findings were not consistent with either of these entities, since they revealed an acute bacterial abscess. The most adequate term is thus the more generic name of septic cutaneous granular abscess., (Copyright © 2016 Elsevier Masson SAS. All rights reserved.)

Objectives: The study objectives were to describe an outbreak of skin infections in school settings, caused by Staphylococcus aureus carrying Panton-Valentine leukocidin genes (Sa PVL(+)), over a 2-year period. Nasal colonization prevalence was assessed in families where new skin infections occurred, despite a prevention and control strategy., Patients and Methods: A retrospective investigation of skin infections likely to be related to Sa and prospective monitoring and treatment of new infections occurring in pupils and their family members were implemented in October 2006, following the reporting of Sa PVL(+) abscesses and furuncles in a primary school. Additional nasal screening was performed in families where new skin infections occurred, after an initial systematic screening of Sa PVL(+) nasal carriers., Results: On October 31, 2008, 53 patients, accounting for 30 households, had developed 69 skin infections, in four decreasing outbreaks. The cumulative incidence of a first skin infection was 34.6% in primary classes, 21.3% in nursery schools, and 6.5% in the pupils' family households. Several skin infections were reported in 13 households, and in one of them, all of the seven family members had developed at least one skin infection during follow-up. The estimated frequency of nasal colonization ranged from 14.1% to 19.5% according to successive nasal screenings., Conclusion: Early reporting of skin infection clusters is necessary to reinforce the effectiveness of hygiene and prevention measures, and thus limit the risk of a long-lasting outbreak., (Copyright © 2011 Elsevier Masson SAS. All rights reserved.)

Purpose: To determine the prevalence of methicillin-resistant Staphylococcus aureus in community-acquired skin infections in Lomé, Togo., Patients and Methods: A prospective study including 90 cases of skin infection observed in dermatological outpatients at the teaching Hospital of Lomé was carried out from 1st June 2003 to 30th May 2005. A bacteriological sample with antibiograms was obtained from all patients., Results: Mean patient age was 21 years (extremes, 6 months to 78 years). The male-to- female ratio was 0.84. Infection was primary in 80% of cases including impetigo in 42.2%, follicular infection in 28.9%, and abscess in 8.9% and secondary in 20% of cases including eczema in 8.9%, mycosis in 3.3%, and other in 7.8%. Staphylococcus aureus strains were isolated in a total of 84 cases (93.3%). Staphylococcus aureus occurred alone in 79 cases (87.8%) or in association with other bacteria in 5. A total of 30 of the 84 Staphylococcus aureus strains (35.7%) isolated were methicillin-resistant. Resistant strains were associated with primary infection in 24 cases and secondary infection in 6. CONCLUSION. Staphylococcus aureus is the most common cause of community-acquired skin infections in Lomé. One third of Staphylococcus aureus strains are methicillin-resistant. These findings should be taken into account in daily practice for prescription of antibiotics to patients presenting these infections.

We report a 24-year-old man with a known Behcet's disease who was lost to follow-up for a year. The patient was admitted for the association of scrotal ulceration and inguinal folliculitis, suggesting a Behcet's disease flare-up. Necrotizing course of the folliculitis led to the diagnosis of skin infection caused by a community-acquired methicillin-resistant Staphylococcus aureus strain, carrying Panton-Valentine leukocidin genes. Bacteriological analysis should be mandatory in the absence of specific criteria for the diagnosis of Behcet's disease.

Two bacterial species are responsible for the majority of children skin infections: Streptococcus pyogenes and Staphylococcus aureus. If S. pyogenes remain susceptible to the beta-lactams, their resistance to macrolides varies over time but remains significant (> 10%). In France, most resistant strains are by modification of the target, coded by the gene erm b. For S. aureus, almost all strains isolated were resistant to G and A penicillins, but remain susceptible to M penicillin and cephalosporins. In France, the incidence of methicillin resistant community acquired S. aureus strains is currently low, around 6 %, but the risk of a rapid increase is real.

Objective: The methicillin resistance of Staphylococcus aureus MRSA is a major problem for human infections. The authors present a genotypic study of these bacteria to understand the spreading of these strains in a university hospital., Patients and Methods: We collected 19 strains of MRSA (September 2003-March 2004) for which the presence of gene mecA had been confirmed by PCR. They were then genotyped in pulsed-field Gel electrophoresis (CHEF variety)., Results: Resistant strains accounted for 12.9% of all collected S. aureus strains. Most samples came from patients hospitalized or consulting in dermatology. Eleven different antibiotypes and four genotypic profiles were determined: type A (with 8 subtypes), type B (with 2 subtypes), type C, and D., Conclusion: MRSA strains have a multiclonal distribution in our hospital with a dominant endemic clone in the dermatological unit. Skin infections are the main hospital source for these strains.

Background: Increased frequency of methiresistant Staphylococcus aureus (MRSA) in inpatients is a day to day problem., Objective: To determine the origin of MRSA, the causes for contamination, and potential complications in a department of Dermatology., Patients and Methods: A retrospective study of patients hospitalized in a dermatology department with cutaneous MRSA during 1997-1998. We considered age, type and duration of dermatitis, geographic origin of patients on admission, previous hospitalizations, time between arrival in the ward and positive MRSA, and complications requiring systemic antibiotics., Results: Out of 4579 of our patients, 53 (0.011 p. 100) had positive MRSA. They were on average 70.86 years-old (26 to 97). The most common underlying dermatitis was leg ulcers (30) and foot sores (4). Dermatitis had lasted for more than 1 month in 48 patients. Most of the patients (40) had their MRSA on admission to our ward. Twenty six patients admitted from home had MRSA; only 9 had never been in an hospital. Six patients had diabetes mellitus. Thirty two patients healed with local treatment for their dermatitis. Thirteen patients have had some complications (erysipela 1, osteoarthritis 3, septicemia 2, febrile syndrome 9)., Discussion: Most patients with MRSA had leg ulcers or foot sores, confirming liability of chronic wounds to MRSA colonizing. Thirty one out of 40 patients with MRSA at arrival had been previously hospitalized. Hospitalization increases the risk of MRSA contamination. Treatment of MRSA is essentially that of the underlying dermatitis. However, it is still necessary to monitor the lesion for complications.

To determine potential usefulness of antimicrobial agents and to guide their prescription in the treatment of leprosy plantar ulcers, we conducted an in vitro study about germs' nature and sensitivity to antibiotics. We took samples of plantar ulcers secretion from 107 patients at Marchoux Institute. 92.5% of those ulcers were infected. These samples revealed 145 strains of micro-organisms among those, Staphylococcus aureus (70 strains) and genus Pseudomonas (41 strains) were the most frequent. These bacteria were resistant to several antibiotics currently used at Marchoux Institute (tetracycline, penicillin, cotrimoxazol and erythromicin). Antibiotics, efficient at 80% on tested strains, were expensive for patients. They cannot be recommended for the treatment of local infections. These results outline that the main treatment in plantar ulcers is based upon antiseptic solutions and keeping feet at rest. Antibiotherapy in case of extension of local infection would be based on the results of a previous study of sensitivity.