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Abstract
Strains of Staphylococcus aureus isolated from toxic epidermal necrolysis and Ritter’s disease (named collectively “Ritter’s type” of TEN) and from extensive cases of impetigo contagiosa, in which the diagnosis of Ritter’s type of TEN was considered seriously, were assigned to group E (extensive lesions) and were compared with strains of S. aureus isolated from unequivocal impetigo contagiosa (group L—localised lesions); 24 of the 26 isolates examined belonged to phage-group II.
Strains from groups E and L were generally similar in their patterns of proteolytic activity, low incidence of positive egg-yolk reaction, possession of lipase and production of hyaluronidase. The difference lay in the many isolates in group E that produced a low-titre lysin active against rabbit red cells that was not α-haemolysin. The average titre of lysin active against rabbit erythrocytes in group E was 355 MHD per mi and in group L 1008 MHD per mi. Reasons are given for supposing that this low titre rabbit cell lysin is identical with staphylococcal δ-toxin. It is suggested that δ-toxin may play a part in the pathogenesis of Ritter’s type of TEN and extensive impetigo.
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