Staphylococcal septicemia in children with atopic dermatitis

Atopic dermatitis (AD) is frequently complicated by minor bacterial superin fections, Invasive infections such as osteomyelitis have rarely been report ed. We describe two children with staphylococcal septicemia during an exace rbation of their AD. Cellulitis and underlying congenital heart disease, re spectively, were considered predisposing factors for the development of bac teremia, Identical strains were isolated from the skin, and there was a sig nificant increase in antibodies against Staphylococcus aureus capsular poly saccharide in one child. Our cases demonstrate the potential severity of ba cterial skin infections in AD, especially when associated with an underlyin g condition that increases vulnerability to bacteremia, While their true in cidence in children with AD is currently unknown, it is conceivable that sy stemic staphylococcal infections may be more common than previously thought . Staphylococcal bacteremia has to be considered in the differential diagno sis of fever in children with severe AD. Conversely, episodes of staphyloco ccal bacteremia should prompt a search for underlying predisposing factors.