Clinical features and abnormal neutrophil function in disseminated staphylococcal disease.

Clinical features and immune status have been studied in seven previously healthy children with disseminated staphylococcal disease. Six of seven patients had a history of a viral-type illness before developing disseminated staphylococcal disease. Five patients had a petechial rash. Endocarditis occurred in three patients, two of whom had a cerebral embolism. All seven patients had an abnormal urinary sediment, and in two it was suggestive of glomerulonephritis. Two had transient renal failure. Three patients had evidence of pneumonia, one of the three developed pneumatoceles and one developed a pleural effusion. Four had osteomyelitis and/or septic arthritis. All patients had a transient abnormality of intracellular bacterial killing by neutrophils. One patient died. Three patients have residual valvular heart disease; one of the three patients has weakness of one arm and another has a seizure disorder. Cellular and humoral immunity in all six surviving patients is normal. We speculate that an antecedent viral infection temporarily suppressed neutrophil function and predisposed these children to secondary and severe staphylococcal disease.