Ken-ichi Muramatsu¹, Hiroki Nagasawa¹, Kouhei Ishikawa¹, Soichiro Ota¹, Hiromichi Ohsaka¹, Kei Jitsuiki¹, Youichi Yanagawa^1,

A 75-year-old man with unconsciousness in supine position was found in his garden by a local welfare officer in summer season. His clothes were normal with long pants. He had diabetes mellitus, cerebral infarction, and prostate hypertrophy treated by drugs. His activities of daily living was independent and lived alone. His mother died of stroke and father died of heart disease. When emergence medical technicians checked him, he was in coma, shock and hyperthermic state so that he was transported to our hospital after undergoing tracheal intubation and rapid infusion of cooled lactated Ringer fluid by a dispatched physician. On arrival, he had multiple blisters and erosions on bilateral medial side of thighs and front side of legs. He underwent diagnosis of septic shock, aspiration pneumonia and unknown cause of bilateral leg skin lesions after examinations. He underwent antibiotics and vasopressor in intensive care unit. All skin lesions were managed by ointment. His unstable circulation and respiratory failure improved and was extubated in the day 6. Result of blood culture on arrival was Staphylococcus lugdunensis. He complained legs pain after extubation. All skin lesions in bilateral legs became eschar. He underwent escharotomy and skin draft on day 20 and became temporally septic shock again during operation. He underwent antibiotics again. After control of skin lesions, he was transferred to the other hospital for rehabilitation. The present study demonstrated a case of Staphylococcus lugdunensis bacteremia accompanying staphylococcal scalded skin syndrome like skin lesions. Further study is needed to understand the skin lesions induced by Staphylococcus lugdunensis.

Staphylococcus lugdunensis, septic shock, staphylococcal scalded skin syndrome